NPIMap

Organization Active NPI

Residential Adolescent Adult Seervices & Training, Inc.

  • Community/Behavioral Health Agency
  • Raleigh, NC
National Provider Identifier
1184945693
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL092-503 Issued in NC
Legal business name
RESIDENTIAL ADOLESCENT ADULT SEERVICES & TRAINING, INC.
Practice address
304 W. Millbrook Rd.
Ste. F.
Raleigh, NC 27609-4373
Phone
(919) 329-2630
Fax
(919) 329-2631
NPI assigned
Jun 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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

Authorized official

Name
Mr. Ignacio Roberto Kirk
Title
Owneer/Ceo
Phone
(919) 329-2630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL092-503 NC Primary

Addresses

Primary practice location

304 W. Millbrook Rd.
Ste. F.
Raleigh, NC 27609-4373

Mailing address

304 W. Millbrook Rd.
Ste. F.
Raleigh, NC 27609-4373
Phone (919) 329-2630

Other identifiers 1

IdentifierTypeStateIssuer
5908441MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Handy'S House9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276819200000",
    "number": "1184945693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W. MILLBROOK RD.",
            "address_2": "STE. F.",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094373",
            "telephone_number": "919-329-2630",
            "fax_number": "919-329-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W. MILLBROOK RD.",
            "address_2": "STE. F.",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094373",
            "telephone_number": "919-329-2630",
            "fax_number": "919-329-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL ADOLESCENT ADULT SEERVICES & TRAINING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-18",
        "last_updated": "2010-06-18",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "IGNACIO",
        "authorized_official_middle_name": "ROBERTO",
        "authorized_official_title_or_position": "OWNEER/CEO",
        "authorized_official_telephone_number": "919-329-2630",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL092-503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908441",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.