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Organization
AGAVE MEDICAL CA PC
Active
Organization
AGAVE MEDICAL CA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ORI FRUHAUF (OWNER)
(551) 302-1794
Entity
Organization
Contact information
Practice address
16397 ROAD 37, MADERA, CA 93636-8224
(929) 209-6109
Mailing address
359 5TH ST UNIT 3, JERSEY CITY, NJ 07302-2329
(929) 209-6109
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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