Provider Demographics
NPI:1891099297
Name:AGAPE RESILIENCY TRAINING
Entity Type:Organization
Organization Name:AGAPE RESILIENCY TRAINING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER-HOOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-900-6293
Mailing Address - Street 1:1516 E TROPICANA AVE STE 137
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6552
Mailing Address - Country:US
Mailing Address - Phone:702-530-2788
Mailing Address - Fax:
Practice Address - Street 1:1516 E TROPICANA AVE STE 137
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6552
Practice Address - Country:US
Practice Address - Phone:702-530-2788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty