Organization
AGAPE STORGE HEALTHCARE SERVICES, INC
Active
Other names
Serenity Safe-Haven Outpatient Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA SUE BLAND (CEO)
(267) 944-1271
Entity
Organization
Contact information
Practice address
921 PLEASANT VALLEY AVE STE 385, MOUNT LAUREL, NJ 08054-1210
(267) 944-1271
(856) 494-1303
Mailing address
921 PLEASANT VALLEY AVE STE 385, MOUNT LAUREL, NJ 08054-1210
(267) 944-1271
(856) 494-1303
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106S00000X
Behavior Technician
—
—
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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