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General NPI Number Information
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NPI Number | 1063224582
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Entity Type | Organization
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Legal Business Name | AGAPE MENTAL HEALTH
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 1030 SKYLINE DRIVE UNIT 21
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City | DRACUT
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State | MA
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Zip | 01826
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Country | US
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Telephone | 603-475-1485
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Fax |
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Provider Business Mailing Address
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Address Line | 265 CHELMSFORD ST STE 7
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City | CHELMSFORD
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State | MA
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Zip | 01824-2335
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Country | US
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Telephone | 603-475-1485
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | IVANA FELICE SANINOCENCIO
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Credential |
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Telephone | 603-475-1485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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