Organization
RHA HEALTH SERVICES NC, LLC
Active
Other names
Bear Creek
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER D LOZANO (DIRECTOR OF REVENUE CYCLE)
(404) 968-2663
Entity
Organization
Contact information
Practice address
5840 GREENWOOD DR, LA GRANGE, NC 28551-6815
(252) 566-9181
(252) 566-2912
Mailing address
1819 PEACHTREE RD NE, STE 450, ATLANTA, GA 30309-1848
(404) 364-2900
(404) 364-2901
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL-054-006
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-054-006
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3416034
—
NC
Enumeration date
12/06/2006
Last updated
09/18/2015
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