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Contact Information

AGAPE
9378 OLIVE BLVD
SUITE 317
OLIVETTE, MO63132-3215
 Phone: 314-994-9344
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for AGAPE

NPI # 1235522673
LBN Legal business name AGAPE
Authorized official DARRELL PROVINSE - (PRESIDENT/EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 03/10/2015
Last updated 03/10/2015 - About 11 years ago
Identifiers
IL License # 180-001482
MO License # 2003031617
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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