Provider Demographics
NPI:1588177620
Name:AGAPE TREATMENT SOLUTIONS
Entity Type:Organization
Organization Name:AGAPE TREATMENT SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SALENA
Authorized Official - Middle Name:ETHALENA, ARNETTA
Authorized Official - Last Name:MANAOIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LAC, LPCC, CNA
Authorized Official - Phone:719-232-7981
Mailing Address - Street 1:4725 MEADOWLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-2609
Mailing Address - Country:US
Mailing Address - Phone:719-232-7981
Mailing Address - Fax:
Practice Address - Street 1:1353 S 8TH ST STE 202
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-7341
Practice Address - Country:US
Practice Address - Phone:719-232-7981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-12
Last Update Date:2017-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty