1134886609 NPI number — RHI OF MIDDLE GEORGIA LLC

Table of content: (NPI 1134886609)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134886609 NPI number — RHI OF MIDDLE GEORGIA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RHI OF MIDDLE GEORGIA LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134886609
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 W RENNER RD STE 420
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHARDSON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75082-2022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-587-0121
Provider Business Mailing Address Fax Number:
972-468-0022

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
912 BELLEVUE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUBLIN
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31021-4850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-621-7380
Provider Business Practice Location Address Fax Number:
478-246-0946
Provider Enumeration Date:
11/19/2021

Additional Information

Authorized Official

Authorized Official Last Name:
MABERRY
Authorized Official First Name:
DONNIE
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
806-587-0121

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: HSPC001461 . This is a "STATE OPERATORS LICENSE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




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