Provider Demographics
NPI:1467587931
Name:RHA HEALTH SERVICES NC LLC
Entity Type:Organization
Organization Name:RHA HEALTH SERVICES NC LLC
Other - Org Name:ELM STREET
Other - Org Type:Other Name
Authorized Official - Title/Position:SVP FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:D
Authorized Official - Last Name:LOZANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-630-7290
Mailing Address - Street 1:3060 PEACHTREE RD NW
Mailing Address - Street 2:SUITE 900
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2234
Mailing Address - Country:US
Mailing Address - Phone:404-364-2900
Mailing Address - Fax:404-364-2901
Practice Address - Street 1:500 SAINT ST
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-8433
Practice Address - Country:US
Practice Address - Phone:919-894-5124
Practice Address - Fax:919-894-1488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7803254Medicaid