Organization
RHA HEALTH SERVICES NC, LLC
Active
Other names
Shelbourne
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
2524 SHELBURNE PL, CHARLOTTE, NC 28227-9554
(704) 545-7075
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-060-390
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL-060-390
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3426140
—
NC
Enumeration date
12/17/2006
Last updated
09/19/2015
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