Provider Demographics
NPI:1629119326
Name:RESIDENTIAL ADOLESCENT ADULT SERVICES AND TRAINING, INC.
Entity Type:Organization
Organization Name:RESIDENTIAL ADOLESCENT ADULT SERVICES AND TRAINING, INC.
Other - Org Name:HANDY'S HOUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:IGNACIO
Authorized Official - Middle Name:ROBERTO
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-696-6071
Mailing Address - Street 1:304 W MILLBROOK RD STE F
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4373
Mailing Address - Country:US
Mailing Address - Phone:919-431-0809
Mailing Address - Fax:919-431-0404
Practice Address - Street 1:7301 BASSETT HALL CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-5632
Practice Address - Country:US
Practice Address - Phone:919-862-0298
Practice Address - Fax:919-862-0299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-092-587320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness