# AGAPE HARBOR SPEECH THERAPY AND REHABILITATION, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154672582
- **Authorized official:** DR. MISTY ANN MASON (SPEECH-LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (602) 999-6358

## Contact information

- **Practice address:** 16195 W COTTONWOOD ST, SURPRISE, AZ 85374-5740
- **Practice address phone:** (602) 999-6358
- **Practice address fax:** (623) 234-2802
- **Mailing address:** 16195 W COTTONWOOD ST, SURPRISE, AZ 85374-5740
- **Mailing address phone:** (602) 999-6358
- **Mailing address fax:** (623) 234-2802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | SLP-4062 | AZ | Yes |

## Other

- **Enumeration date:** 09/25/2012
- **Last updated:** 09/25/2012