RHA HEALTH SERVICES NC LLC NPI 1265567739

NPI Information

NPI: 1265567739
Provider Name: RHA HEALTH SERVICES NC, LLC

Other Name: WAKE COUNTY GROUP HOME #2

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization

CLIA Number: 34D2211953

Address:
4808 WHITEHALL AVE
RALEIGH, NC
ZIP 27604
Phone: (919) 528-2558
Get Directions

RHA HEALTH SERVICES NC, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Raleigh, NC. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. RHA HEALTH SERVICES NC, LLC NPI is 1265567739. The provider is registered as an organization entity type.
The provider Other Name Is Wake County Group Home #2.

The provider's business location address is:

4808 WHITEHALL AVE
RALEIGH, NC
ZIP 27604-732
Phone: (919) 528-2558
Fax: (919) 528-2971

The provider's authorized official is Jennifer D Lozano .
The authorized official title is Director and has the following contact phone number (404) 364-2900.

The CLIA number assigned to this NPI record is 34D2211953 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/23/2007 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7803984	MEDICAID	NORTH 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: 4/28/2024

NPI Synchronization or Removal

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