Organization Name: | AGAPE COUNSELING SERVICES |
NPI Number: | 1427492263 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROY W MINNIX (CLINICAL DIRECTOR) |
Mailing Address: | 815 Route 9 Lanoka Harbor |
State: | NJ US |
Postal Code: | 087341706 |
Phone Number: | 6092420086 |
Fax Number: | 6092420087 |
NPI Enumeration Date: | 04/23/2013 |
NPI Last Update Date: | 10/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | 2000190 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
Taxonomy Definition: |