Basic Information
| Provider Information | |||||||||
| NPI: | 1467743328 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RHA HEALTH SERVICES NC, LLC | ||||||||
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| OtherOrganizationName: | LUMBERTON | ||||||||
| 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 | ||||||||
| FaxNumber: | 4043642901 | ||||||||
| Practice Location | |||||||||
| Address1: | 2003 GODWIN AVE | ||||||||
| Address2: | A1 | ||||||||
| City: | LUMBERTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283583149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107391468 | ||||||||
| FaxNumber: | 9107396134 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2011 | ||||||||
| LastUpdateDate: | 09/19/2015 | ||||||||
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| AuthorizedOfficialLastName: | LOZANO | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4043642900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MBA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.