Organization
RESIDENTIAL ADOLESCENT ADULT SERVICES AND TRAINING, INC.
Active
Organization
RESIDENTIAL ADOLESCENT ADULT SERVICES AND TRAINING, INC.
Active
Other names
Brooklyn's House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IGNACIO ROBERTO KIRK (CEO-OWNER)
(919) 696-6071
Entity
Organization
Contact information
Practice address
4717 WINDBREAK LN, RALEIGH, NC 27616-0740
(919) 862-0298
(919) 862-0299
Mailing address
7301 BASSETT HALL CT, RALEIGH, NC 27616-5632
(919) 431-0809
(919) 431-0404
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-092-503
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6604026
—
NC
Enumeration date
02/08/2007
Last updated
08/22/2020
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