Organization
AGAPE COMMUNITY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILLIAN SCHELLHAMMER (CREDENTIALING SPECIALIST)
(904) 800-6347
Entity
Organization
Contact information
Practice address
6024 MERRILL RD, JACKSONVILLE, FL 32277-3427
(904) 760-4904
(904) 743-7436
Mailing address
120 KING ST, JACKSONVILLE, FL 32204-2410
(904) 800-6347
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017234423
—
FL
Enumeration date
08/30/2021
Last updated
08/30/2021
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