Organization
AGAPE HEALTH & WELLNESS CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY HART (CREDENTIALING/BILLING MANAGER)
(904) 300-7494
Entity
Organization
Contact information
Practice address
6138 KENNERLY RD STE AND150, JACKSONVILLE, FL 32216-4393
(386) 283-2010
Mailing address
11555 CENTRAL PKWY STE 601, JACKSONVILLE, FL 32224-2698
(386) 283-2010
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
174H00000X
Health Educator
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2575228
—
FL
Enumeration date
04/06/2021
Last updated
04/19/2024
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