Provider Demographics
NPI:1821120502
Name:AGAPE CHILD AND FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:AGAPE CHILD AND FAMILY SERVICES, INC.
Other - Org Name:AGAPE
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:901-323-3600
Mailing Address - Street 1:111 RACINE ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-2707
Mailing Address - Country:US
Mailing Address - Phone:901-323-3600
Mailing Address - Fax:901-323-3640
Practice Address - Street 1:111 RACINE ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-2707
Practice Address - Country:US
Practice Address - Phone:901-323-3600
Practice Address - Fax:901-323-3640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty