Basic Information
| Provider Information | |||||||||
| NPI: | 1134589005 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RHA BEHAVIORAL HEALTH NC LLC | ||||||||
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| OtherOrganizationName: | PIEDMONT HOUSE | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1819 PEACHTREE RD NE | ||||||||
| Address2: | STE 450 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303091848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043642900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 233 MONTGOMERY AVE | ||||||||
| Address2: | STE 2-A | ||||||||
| City: | ALBEMARLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280014081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7049834157 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2016 | ||||||||
| LastUpdateDate: | 03/04/2016 | ||||||||
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| AuthorizedOfficialLastName: | LOZANO | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | VP - FINANCIAL SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 4049682663 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MBA, CPC-P | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.