Residential Adolescent Adult Seervices & Training, Inc.

Community/Behavioral Health

Agencies

304 W. Millbrook Rd., Ste. F., Raleigh, NC 27609-4373

PECOS Enrollment

Based on the most recent information from CMS, provider Residential Adolescent Adult Seervices & Training, Inc. does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1184945693
Provider Type
Organization
Full Name
Residential Adolescent Adult Seervices & Training, Inc.

Subpart
No
Enumeration Date
6/18/2010
Last Updated
6/18/2010

Contact Information

Practice Location

304 W. Millbrook Rd., Ste. F., Raleigh, NC 27609-4373

(919) 329-2630

(919) 329-2631

Mailing Location

304 W. Millbrook Rd., Ste. F., Raleigh, NC 27609-4373

(919) 329-2630

(919) 329-2631

Authorized Official

Kirk, Ignacio Roberto (Owneer/Ceo)

(919) 329-2630

Provider Taxonomies

Code	Description	License
Code 251S00000X Primary	Description Community/Behavioral Health Agencies	License MHL092-503 North Carolina

Provider Identifiers

ID	Description	Issuer
ID 5908441	Description Medicaid	Issuer Unlisted North Carolina

Residential Adolescent Adult Seervices & Training, Inc.

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

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