Americorp Behavioral Health LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-09-2503 Issued in NC

Legal business name

AMERICORP BEHAVIORAL HEALTH LLC

Practice address

304 W Millbrook Rd Ste F
Raleigh, NC 27609-4381

Phone

(919) 329-2630

NPI assigned

Oct 5, 2014

Last updated

Mar 30, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ignacio Kirk

Title

Ceo

Phone

(919) 696-6071

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1412467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1831592864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 MAIN ST STE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013266",
            "telephone_number": "919-696-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W MILLBROOK RD STE F",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094381",
            "telephone_number": "919-329-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICORP BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-05",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "IGNACIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-696-6071",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C 000396",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-09-2503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.