Provider Demographics
NPI:1720562697
Name:CDAGAPE
Entity Type:Organization
Organization Name:CDAGAPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/ CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC
Authorized Official - Phone:313-715-9577
Mailing Address - Street 1:1098 ANN ARBOR RD W
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-2129
Mailing Address - Country:US
Mailing Address - Phone:248-978-5862
Mailing Address - Fax:
Practice Address - Street 1:1098 ANN ARBOR RD W
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-2129
Practice Address - Country:US
Practice Address - Phone:248-978-5862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty