NPIMap

Organization Active NPI

Rha Health Services NC, LLC

  • Intellectual Disabilities Intermediate Care Facility
  • Maiden, NC
National Provider Identifier
1336284884
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
RHA HEALTH SERVICES NC, LLC
Practice address
631 Old Park Rd
Maiden, NC 28650-9486
Phone
(828) 428-0061
Fax
(828) 428-3600
NPI assigned
Feb 21, 2007
Last updated
Sep 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer D Lozano
Title
Director of Revenue Cycle
Phone
(404) 364-2900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

631 Old Park Rd
Maiden, NC 28650-9486

Mailing address

1819 Peachtree Rd NE
Ste 450
Atlanta, GA 30309-1848
Phone (404) 364-2900

Other identifiers 1

IdentifierTypeStateIssuer
3406523MedicaidNC

Other names 1

  • WENDOVER Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336284884. Details of each certification follow.

  • CCN 34G119 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 34G119

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
WENDOVER HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Aug 30, 1989
Last certification
Jun 25, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
631 Old Park Road
Maiden, NC 28650

National Provider Directory

National Provider Directory
Tax ID family
Rha Health Services NC LLC351 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

631 Old Park Rd
Maiden, NC 28650
Phone (828) 428-0061

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1336284884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 PEACHTREE RD NE",
            "address_2": "STE 450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091848",
            "telephone_number": "404-364-2900",
            "fax_number": "404-364-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 OLD PARK RD",
            "city": "MAIDEN",
            "state": "NC",
            "postal_code": "286509486",
            "telephone_number": "828-428-0061",
            "fax_number": "828-428-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHA HEALTH SERVICES NC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "LOZANO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "404-364-2900"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406523",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WENDOVER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Maiden, NC

Sources for this page

Verify at the official NPI Registry.