Provider Demographics
NPI:1053686766
Name:AGAPE COMMUNITY SOCIAL SERVICES, INC
Entity Type:Organization
Organization Name:AGAPE COMMUNITY SOCIAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:ECHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED INDIVIDUAL
Authorized Official - Phone:240-393-0341
Mailing Address - Street 1:2412 MINNESOTA AVENUE SE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5300
Mailing Address - Country:US
Mailing Address - Phone:202-506-2970
Mailing Address - Fax:202-506-2972
Practice Address - Street 1:2412 MINNESOTA AVENUE SE
Practice Address - Street 2:SUITE 104
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5300
Practice Address - Country:US
Practice Address - Phone:202-506-2970
Practice Address - Fax:202-506-2972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC50078853251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management