Organization
AGAPE WELLNESS AND FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAILEY C MATTISON BA (CEO)
(702) 578-3035
Entity
Organization
Contact information
Practice address
7100 GRAND MONTECITO PKWY, UNIT 3063, LAS VEGAS, NV 89149-0282
(702) 578-3035
Mailing address
6112 RIVEROAK TER, ATLANTA, GA 30349-4078
(770) 580-0960
(702) 974-1342
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
16140110
GA
Other
Enumeration date
03/20/2014
Last updated
03/20/2014
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