AGAPE SERVICES INC

Provider Demographics

• NPI: 1023305208
• Name: AGAPE SERVICES INC
• Entity type: Organization
• Organization Name: AGAPE SERVICES INC
• Authorized Official - Title/Position: CEO
• Authorized Official - Prefix: MR
• Authorized Official - First Name: WILLIAM
• Authorized Official - Middle Name: JEFFERY
• Authorized Official - Last Name: MASSEY
• Authorized Official - Phone: 704-225-0584
• Mailing Address - Street 1: PO BOX 3319
• Mailing Address - Street 2: 806 CIRCLE DRIVE
• Mailing Address - City: MONROE
• Mailing Address - State: NC
• Mailing Address - Zip Code: 28111-3319
• Mailing Address - Country: US
• Mailing Address - Phone: 704-225-0584
• Mailing Address - Fax: 800-755-9281
• Practice Address - Street 1: 806 CIRCLE DR
• Practice Address - City: MONROE
• Practice Address - State: NC
• Practice Address - Zip Code: 28112-3800
• Practice Address - Country: US
• Practice Address - Phone: 704-225-0584
• Practice Address - Fax: 800-755-9281
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2011-07-07
• Last Update Date: 2013-03-22

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	251S00000X	Agencies	Community/Behavioral Health
No	320900000X	Residential Treatment Facilities	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		Group - Multi-Specialty
No	310400000X	Nursing & Custodial Care Facilities	Assisted Living Facility		Group - Multi-Specialty
No	251C00000X	Agencies	Day Training, Developmentally Disabled Services		Group - Multi-Specialty
No	253J00000X	Agencies	Foster Care Agency
No	1041C0700X	Behavioral Health & Social Service Providers	Social Worker	Clinical	Group - Multi-Specialty
No	101YP2500X	Behavioral Health & Social Service Providers	Counselor	Professional	Group - Multi-Specialty
No	101YA0400X	Behavioral Health & Social Service Providers	Counselor	Addiction (Substance Use Disorder)	Group - Multi-Specialty
No	261QM0801X	Ambulatory Health Care Facilities	Clinic/Center	Mental Health (Including Community Mental Health Center)

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NC	6008247	Medicaid
NC	8303172	Medicaid
NC	8303351	Medicaid
NC	8303350	Medicaid
NC	5916011	Medicaid
NC	8301179	Medicaid
NC	6603310	Medicaid
NC	6603506	Medicaid
NC	6603913	Medicaid
NC	6604025	Medicaid