MEDICARE: RHA HEALTH SERVICES NC, 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	315P00000X	Intellectual Disabilities Intermediate Care Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942345459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RHA HEALTH SERVICES NC, LLC

Provider Business Mailing Address
First Line	:	1819 PEACHTREE RD NE
Second Line	:	STE 450
City	:	ATLANTA
State	:	GA
Zip	:	30309-1848
Country	:	US
Telephone Number	:	404-364-2900
Fax Number	:	404-364-2901

Provider Business Practice Location Address
First Line	:	4795 STANLEY RD
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-9604
Country	:	US
Telephone Number	:	919-528-2558
Fax Number	:	919-528-2971

Authorized Official
Title or Position	:	DIRECTOR OF REVENUE CYCLE
Name	:	JENNFER D LOZANO
Credential	:
Telephone Number	:	404-364-2900

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	10/23/2015

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