Agape Life Multicultural Services
Nurse Practitioner in Grand Prairie, TX. Organization (NPI-2).
NPI number1609698455
StatusActive
Last updated in NPPESOct 31, 2024
Details
- NPI
- 1609698455
- Entity type
- Organization (NPI-2)
- Legal business name
- Agape Life Multicultural Services
- Organization subpart
- No
- Enumeration date
- Oct 31, 2024
- Certification date
- Oct 31, 2024
- Last updated
- Oct 31, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
| 363LA2200X | Nurse Practitioner, Adult Health | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Practice location
2100 Virginia St Ste FGrand Prairie, TX 75051-3796
Phone 214-862-5756 · Fax 469-332-3118
Mailing address
1024 Fair Oaks DrGrand Prairie, TX 75052-2718
Phone 214-862-5756 · Fax 469-332-3118
Authorized official
Karan Staggers
Ceo
2148625756
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