Organization
AGAPECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EMERYNE GAHIMBARE (CEO/ADMINISTRATOR)
(930) 430-1469
Entity
Organization
Contact information
Practice address
6724 S 4TH ST, PHOENIX, AZ 85042-7685
(937) 430-1469
Mailing address
6724 S 4TH ST, PHOENIX, AZ 85042-7685
(937) 430-1469
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH6919
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
10/18/2021
Last updated
10/18/2021
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