| Organization Name: | AGAPE COUNSELING CENTER LLC |
| NPI Number: | 1063744662 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MYRA JEAN HECKENLAIBLE-GOTTO (LICENSED PSYCHOLOGIST) |
| Mailing Address: | 305 9th St Windom |
| State: | MN US |
| Postal Code: | 561011658 |
| Phone Number: | 5078328033 |
| Fax Number: | 5078328298 |
| NPI Enumeration Date: | 02/06/2010 |
| NPI Last Update Date: | 02/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |