Healthcare Provider Details

I. General information

NPI: 1689586364
Provider Name (Legal Business Name): AGAPE ENRICHMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 E COURT ST
IOWA CITY IA
52245-4905
US

IV. Provider business mailing address

2929 E COURT ST
IOWA CITY IA
52245-4905
US

V. Phone/Fax

Practice location:
  • Phone: 319-654-4624
  • Fax:
Mailing address:
  • Phone: 319-654-4624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANTHONY SMITH
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 319-654-4624