Provider Demographics
NPI:1598125460
Name:RHA HEALTH SERVICES NC LLC
Entity Type:Organization
Organization Name:RHA HEALTH SERVICES NC LLC
Other - Org Name:MINERAL SPRINGS II
Other - Org Type:Other Name
Authorized Official - Title/Position:VP - 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:MBA, CPC-P
Authorized Official - Phone:404-968-2663
Mailing Address - Street 1:1819 PEACHTREE RD NE
Mailing Address - Street 2:STE 450
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1848
Mailing Address - Country:US
Mailing Address - Phone:404-364-2900
Mailing Address - Fax:404-364-2901
Practice Address - Street 1:410 N MINERAL SPRINGS RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-3618
Practice Address - Country:US
Practice Address - Phone:919-596-7954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities