Basic Information
| Provider Information | |||||||||
| NPI: | 1164014882 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RHA HEALTH SERVICES NC LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1819 PEACHTREE RD NE STE 450 | ||||||||
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| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303091853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043642900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 40163 HIGHWAY 740 | ||||||||
| Address2: | |||||||||
| City: | NEW LONDON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008480180 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/04/2021 | ||||||||
| LastUpdateDate: | 02/04/2021 | ||||||||
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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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| NPICertificationDate: | 01/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.