Organization
AGAPE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ERNEST WILLIAMS (EXECUTIVE DIRECTOR)
(928) 459-3400
Entity
Organization
Contact information
Practice address
2140 W 24TH ST STE B, YUMA, AZ 85364-8877
(928) 459-3400
(928) 459-2077
Mailing address
2140 W 24TH ST STE B, YUMA, AZ 85364-8877
(928) 503-4060
(928) 459-2077
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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