Agape Behavioral Center
Psychologist, Clinical Child & Adolescent in Las Vegas, NV. Organization (NPI-2).
NPI number1972946804
StatusActive
Last updated in NPPESApr 10, 2013
Details
- NPI
- 1972946804
- Entity type
- Organization (NPI-2)
- Legal business name
- Agape Behavioral Center
- Organization subpart
- No
- Enumeration date
- Apr 10, 2013
- Last updated
- Apr 10, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC2200X | Psychologist, Clinical Child & Adolescent | – | – | Yes |
Practice location
3620 N Rancho DrSte. 103
Las Vegas, NV 89130-3155
Phone 702-656-5683
Mailing address
3985 E Cheyenne AveLas Vegas, NV 89115-3212
Phone 702-372-8641
Authorized official
Aveeon Noel Williams
Basic Skills Trainer
7023728641
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