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General NPI Number Information
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NPI Number | 1760765838
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Entity Type | Organization
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Legal Business Name | AGAPE FAMILY EDUCATION PROJECT AND COUNSELING PROGRAM INC.
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Dates
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Enumeration Date | 09/24/2011
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Last Update Date | 09/01/2013
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Provider Practice Location Address
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Address Line | 1372 LANE AVE S
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City | JACKSONVILLE
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State | FL
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Zip | 32205-6885
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Country | US
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Telephone | 904-416-4121
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Fax | 904-781-9182
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Provider Business Mailing Address
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Address Line | 1372 LANE AVE S
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City | JACKSONVILLE
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State | FL
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Zip | 32205-6885
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Country | US
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Telephone | 904-416-4121
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Fax | 904-781-9182
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Authorized Official
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Title or Position | CEO/ADMINISTRATION
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Name | MS. EDNA YOWANDA HERRING-COOPER
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Credential | MFT, CFLE
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Telephone | 904-416-4121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | FL
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