Basic Information
Provider Information
NPI: 1164554507
EntityType: 2
ReplacementNPI:  
OrganizationName: RHA HEALTH SERVICES, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ONSLOW BHS
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3060 PEACHTREE RD NW
Address2: SUITE 900
City: ATLANTA
State: GA
PostalCode: 303052234
CountryCode: US
TelephoneNumber: 4043642900
FaxNumber: 4043642901
Practice Location
Address1: 824 GUM BRANCH RD STE C
Address2:  
City: JACKSONVILLE
State: NC
PostalCode: 285406269
CountryCode: US
TelephoneNumber: 9103479990
FaxNumber: 9106471117
Other Information
ProviderEnumerationDate: 03/12/2007
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ORSINI
AuthorizedOfficialFirstName: KAREN
AuthorizedOfficialMiddleName: LYN
AuthorizedOfficialTitleorPosition: VICE PRESIDENT FINANCIAL SVCS
AuthorizedOfficialTelephone: 4043642900
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

ID Information
IDTypeStateIssuerDescription
8300681H05NC MEDICAID


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