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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