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 11 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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Description

License

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