Provider Demographics
NPI:1679080717
Name:RHA HEALTH SERVICES TN LLC
Entity Type:Organization
Organization Name:RHA HEALTH SERVICES TN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, FINANCIAL SVCS
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 STE 450
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1853
Mailing Address - Country:US
Mailing Address - Phone:404-968-2668
Mailing Address - Fax:
Practice Address - Street 1:305 W HILLCREST DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-3841
Practice Address - Country:US
Practice Address - Phone:828-232-6844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities