Organization
MARY'S HOUSE
Active
Other names
Residential Adolescent Adult Services Training, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IGNACIO KIRK (CEO/OWNER)
(919) 696-6071
Entity
Organization
Contact information
Practice address
304 W MILLBROOK RD STE F, RALEIGH, NC 27609-4381
(919) 329-2630
(919) 896-8117
Mailing address
408 LATIMER RD, RALEIGH, NC 27609-5906
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
NC
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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