Organization
AGAPE CLINIC WITH HEART: A PROFESSIONAL NURSING ORGANIZATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MARIE CLARK FNP-BC, PMHNP-BC (NURSE PRACTITIONER, PRESIDENT)
(707) 757-3117
Entity
Organization
Contact information
Practice address
3114 CARVEL DR, SANTA ROSA, CA 95405-7062
(707) 757-3117
Mailing address
3114 CARVEL DR, SANTA ROSA, CA 95405-7062
(707) 757-3117
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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