Americorp Behavioral Health LLC
Organization Active NPI Emotionally Disturbed Childrens' Residential Treatment Facility · Raleigh, NC
NPI 1831592864 · NPPES record last updated Mar 30, 2015
Key facts
- NPI
- 1831592864
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
- License
- MHL-09-2503 (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
- Organization subpart
- No
Authorized official
- Name
- Mr. Ignacio Kirk
- Title
- Ceo
- Phone
- (919) 696-6071
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | C 000396 | NC | |
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | MHL-09-2503 | NC | Yes |
Addresses
Primary practice location
304 W Millbrook Rd Ste F
Raleigh, NC 27609-4381
Mailing address
1320 Main St Ste 300
Columbia, SC 29201-3266
Phone (919) 696-6071
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6003085 | Medicaid | NC |
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All providers in Raleigh, NC · Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.