MEDICARE: RHA HEALTH SERVICES NJ LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1174374623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RHA HEALTH SERVICES NJ LLC

Provider Business Mailing Address
First Line	:	1819 PEACHTREE RD NE STE 450
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-1853
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 LOWER MATCHAPONIX AVE
Second Line	:
City	:	MONROE TOWNSHIP
State	:	NJ
Zip	:	08831-1424
Country	:	US
Telephone Number	:	732-521-5393
Fax Number	:

Authorized Official
Title or Position	:	SVP FINANCIAL SERVICES
Name	:	JENNIFER LOZANO
Credential	:
Telephone Number	:	770-630-7290

Provider Enumeration Date	:	04/01/2024
Last Update Date	:	04/01/2024

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