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General NPI Number Information
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NPI Number | 1164036299
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Entity Type | Organization
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Legal Business Name | PARTNER WITH AGAPE
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Dates
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Enumeration Date | 09/05/2020
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Last Update Date | 06/05/2022
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Provider Practice Location Address
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Address Line | 5805 COIT RD STE 402
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City | PLANO
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State | TX
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Zip | 75093-6990
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Country | US
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Telephone | 443-525-2070
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Fax |
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Provider Business Mailing Address
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Address Line | 5805 COIT RD STE 402
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City | PLANO
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State | TX
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Zip | 75093-6990
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | CLAIRE NGWA
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Credential |
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Telephone | 443-525-2070
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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