Healthcare Provider Details

I. General information

NPI: 1629767207
Provider Name (Legal Business Name): AGAPES HELPING HANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3833 W 27TH ST
LOS ANGELES CA
90018-2321
US

IV. Provider business mailing address

3833 W 27TH ST
LOS ANGELES CA
90018-2321
US

V. Phone/Fax

Practice location:
  • Phone: 310-251-0245
  • Fax:
Mailing address:
  • Phone: 310-251-0245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: VALENCIA CARILLO
Title or Position: ADMINISTRATOR
Credential:
Phone: 310-251-0245