Basic Information
Provider Information
NPI: 1275824138
EntityType: 2
ReplacementNPI:  
OrganizationName: RHA HEALTH SERVICES INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: FAYETTEVILLE INTENSIVE IN HOME
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: 941 S MCPHERSON CHURCH RD
Address2:  
City: FAYETTEVILLE
State: NC
PostalCode: 283035369
CountryCode: US
TelephoneNumber: 9106091717
FaxNumber: 9106890372
Other Information
ProviderEnumerationDate: 04/27/2011
LastUpdateDate: 04/27/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ORSINI
AuthorizedOfficialFirstName: KAREN
AuthorizedOfficialMiddleName: LYN
AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 4043642900
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MBA
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


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