Provider Demographics
NPI:1235509357
Name:RHA HEALTH SERVICES TN, LLC
Entity Type:Organization
Organization Name:RHA HEALTH SERVICES TN, LLC
Other - Org Name:3353 JACKSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-692-5555
Mailing Address - Street 1:3350 MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0208
Mailing Address - Country:US
Mailing Address - Phone:615-895-7788
Mailing Address - Fax:615-895-6999
Practice Address - Street 1:3353 JACKSON RD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-1350
Practice Address - Country:US
Practice Address - Phone:615-895-7788
Practice Address - Fax:615-895-6999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000012145320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities