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Contact Information

AGAPE LIFE PREVENTION CENTER
6071 HIGHWAY 85 APT 31A
RIVERDALE, GA30274-1531
 Phone: 678-437-7350
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
 

Case Management

251B00000X
 

Meals

174200000X
 

Public Health or Welfare

251K00000X 60 Public Health or Welfare Agency
Indicates primary specialty

NPI Profile & details for AGAPE LIFE PREVENTION CENTER

NPI # 1780316489
LBN Legal business name AGAPE LIFE PREVENTION CENTER
Authorized official TIARA BRACEY - (PREVENTION SPECIALIST)
Entity Organization
Organization subpart 1 No
Enumeration date 06/30/2022
Last updated 06/30/2022 - About 4 years ago
Identifiers
GA Medicaid 000000
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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