Organization
AGAPE CHRISTIAN COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRELL GEORGE PROVINSE (L.P.C., N.C.C)
(314) 746-9622
Entity
Organization
Contact information
Practice address
9378 OLIVE BLVD STE 317, SAINT LOUIS, MO 63132-3224
(314) 746-9622
Mailing address
9378 OLIVE BLVD STE 317, SAINT LOUIS, MO 63132-3224
(314) 746-9622
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2009036114
MO
Other
Enumeration date
02/19/2010
Last updated
02/19/2010
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