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)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
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

IdentifierTypeStateIssuer
6003085MedicaidNC

Other providers in Raleigh, NC

All providers in Raleigh, NC · Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.