Organization
AGAPE CENTER FOR TROUBLED YOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA ANN WATSON LCSW (PROGRAM DIRECTOR)
(318) 787-1114
Entity
Organization
Contact information
Practice address
2013 MACARTHUR DR, BLDG 2, ALEXANDRIA, LA 71301-3720
(318) 787-1114
(318) 487-6287
Mailing address
610 WEBSTER ST, PINEVILLE, LA 71360-6948
(318) 787-1114
(318) 487-6287
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6319
LA
302F00000X
Exclusive Provider Organization
6319
LA
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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