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Organization

AGAPE CHRISTIAN COUNSELING SERVICES

Active
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Organization

AGAPE CHRISTIAN COUNSELING SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DARRELL G PROVINSE LPC (PRESIDENT/EXECUTIVE DIRECTOR)
(314) 994-9344
Entity
Organization

Contact information

Practice address
525 RUE SAINT FRANCOIS, SUITE8, FLORISSANT, MO 63031-5036
(314) 994-9344
(314) 994-3007
Mailing address
9378 OLIVE BLVD, SUITE 317, SAINT LOUIS, MO 63132-3215
(314) 944-9344
(314) 994-3007

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2011031734
MO

Other

Enumeration date
10/28/2011
Last updated
10/28/2011
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