Organization
AGAPE STORGE HEALTHCARE SERVICES, INC
Active
Organization
AGAPE STORGE HEALTHCARE SERVICES, INC
Active
Other names
Serenity Safe Haven Outpatient Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAHIRA DOCKERY CRNP, LCSW (CEO)
(267) 291-4513
Entity
Organization
Contact information
Practice address
8410 BUSTLETON AVE STE 2, PHILADELPHIA, PA 19152-1924
(267) 291-4513
(215) 701-5888
Mailing address
93 OLD YORK RD, SUITE 1-526, JENKINTOWN, PA 19046-3925
(267) 808-8810
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
142980
PA
Other
Enumeration date
05/14/2013
Last updated
03/17/2018
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