NPIMap

Organization Active NPI

Agm Iop/PHP, LLC

  • Adult Mental Health Clinic/Center
  • Olivette, MO
National Provider Identifier
1346630803
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
LC001426559 Issued in MO
Legal business name
AGM IOP/PHP, LLC
Practice address
10199 Woodfield LN
Olivette, MO 63132-2922
Phone
(314) 282-2517
Fax
(314) 845-2798
NPI assigned
Feb 4, 2015
Last updated
Apr 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Franco Sicuro, M.D.
Title
Owner
Phone
(314) 222-0602

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X LC001426559 MO Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X LC001426559 MO

Addresses

Primary practice location

10199 Woodfield LN
Olivette, MO 63132-2922

Mailing address

10199 Woodfield LN
Olivette, MO 63132-2922
Phone (314) 222-0602

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554681600000",
    "number": "1346630803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10199 WOODFIELD LN",
            "city": "OLIVETTE",
            "state": "MO",
            "postal_code": "631322922",
            "telephone_number": "314-222-0602",
            "fax_number": "314-675-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10199 WOODFIELD LN",
            "city": "OLIVETTE",
            "state": "MO",
            "postal_code": "631322922",
            "telephone_number": "314-282-2517",
            "fax_number": "314-845-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGM IOP/PHP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-04",
        "last_updated": "2019-04-08",
        "status": "A",
        "authorized_official_last_name": "SICURO",
        "authorized_official_first_name": "FRANCO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-222-0602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MO",
            "license": "LC001426559",
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MO",
            "license": "LC001426559",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olivette, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.