NPIMap

Organization Active NPI

Rha Health Services TN, LLC

Doing business as 89 Windale

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Jackson, TN
National Provider Identifier
1528438637
Registry record updated Oct 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
L000000012750 Issued in TN
Legal business name
RHA HEALTH SERVICES TN, LLC
Doing business as
89 Windale
Practice address
89 Windale Dr
Jackson, TN 38305-6010
Phone
(731) 855-0537
Fax
(731) 855-1257
NPI assigned
Oct 1, 2015
Last updated
Oct 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2015

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

Authorized official

Name
Wayne Addison
Title
Coo
Phone
(901) 692-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X L000000012750 TN Primary

Addresses

Primary practice location

89 Windale Dr
Jackson, TN 38305-6010

Mailing address

2055 US Highway 45 Byp S
Trenton, TN 38382-3501
Phone (731) 855-0537

Other names 1

  • 89 Windale Doing business as

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 1528438637. Details of each certification follow.

  • CCN 44G148 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 44G148

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
RHA HEALTH SERVICES TN LLC - 89 WINDALE DRIVE
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
May 25, 2011
Last certification
Apr 23, 2025
Beds
4
Ownership / control type
Private (proprietary)
Facility address
89 Windale Dr
Jackson, TN 38305

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2205585Rha 89 Windale89 Windale Drive, Jackson, TN 38305Certificate of waiverDec 14, 2026

National Provider Directory

National Provider Directory
Tax ID family
Rha Health Services TN LLC44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443657600000",
    "number": "1528438637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 US HIGHWAY 45 BYP S",
            "city": "TRENTON",
            "state": "TN",
            "postal_code": "383823501",
            "telephone_number": "731-855-0537",
            "fax_number": "731-855-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 WINDALE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383056010",
            "telephone_number": "731-855-0537",
            "fax_number": "731-855-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHA HEALTH SERVICES TN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-01",
        "status": "A",
        "authorized_official_last_name": "ADDISON",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "901-692-5555"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TN",
            "license": "L000000012750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "89 Windale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.