Provider Demographics
NPI:1396360673
Name:AGAPE AND JOY LLC
Entity Type:Organization
Organization Name:AGAPE AND JOY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIKIA
Authorized Official - Middle Name:SHERRELL
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-327-3495
Mailing Address - Street 1:PO BOX 60404
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32906-0404
Mailing Address - Country:US
Mailing Address - Phone:321-405-9566
Mailing Address - Fax:
Practice Address - Street 1:9400 PINEWOOD DR NE APT 110
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-2317
Practice Address - Country:US
Practice Address - Phone:321-327-3495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities