Provider Demographics
NPI:1831451525
Name:AGAPE CHRISTIAN SERVICES
Entity type:Organization
Organization Name:AGAPE CHRISTIAN SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:432-550-5683
Mailing Address - Street 1:3500 N A ST
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-2554
Mailing Address - Country:US
Mailing Address - Phone:432-550-5683
Mailing Address - Fax:
Practice Address - Street 1:3500 N A ST
Practice Address - Street 2:SUITE 2400
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-2554
Practice Address - Country:US
Practice Address - Phone:432-550-5683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-09
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health