Provider Demographics
NPI:1982330916
Name:AGAR NEUROPSYCHOLOGY GROUP, INC
Entity Type:Organization
Organization Name:AGAR NEUROPSYCHOLOGY GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:C
Authorized Official - Middle Name:
Authorized Official - Last Name:AGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-855-2427
Mailing Address - Street 1:153 E KAMEHAMEHA AVE STE 104-248
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-3424
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:285 W KAAHUMANU AVE STE 202
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1623
Practice Address - Country:US
Practice Address - Phone:866-855-2427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty