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RHA HEALTH SERVICES NC LLC NPI 1871656504


NPI Information

NPI: 1871656504
Provider Name: RHA HEALTH SERVICES NC, LLC

Other Name: TAR RIVER

Classification: Intermediate Care Facility, Mentally Retarded - 315P00000X
Entity Type: Organization

CLIA Number: 34D1072379

Address:
500 SEAN DR
GREENVILLE, NC
ZIP 27834
Phone: (252) 758-1101
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RHA HEALTH SERVICES NC, LLC is an intermediate care facility mentally retarded in Greenville, NC. The provider is (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. RHA HEALTH SERVICES NC, LLC NPI is 1871656504. The provider is registered as an organization entity type.
The provider Other Name Is Tar River.

The provider's business location address is:

500 SEAN DR
GREENVILLE, NC
ZIP 27834-839
Phone: (252) 758-1101

The provider's authorized official is Jennifer Lozano .
The authorized official title is Director Of Revenue Cycle and has the following contact phone number (404) 968-2663.

The CLIA number assigned to this NPI record is 34D1072379 - intermediate care facility/individuals with intellectual disability with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/17/2006 and was last updated on 9/19/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesMHL-074-030NORTH CAROLINANo
2315P00000XIntermediate Care Facility, Mentally RetardedMHL-074-030NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1341604AMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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