Agape Community Health Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

AGAPE COMMUNITY HEALTH CENTER, INC.

Practice address

5300 N Pearl St
Jacksonville, FL 32208-5119

Phone

(904) 760-4904

NPI assigned

Jul 9, 2021

Organization subpart

No

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

Authorized official

Name

Jillian Schellhammer

Title

Credentialing Specialist

Phone

(904) 800-6347

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1508437641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 KING ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322042410",
            "telephone_number": "904-800-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 N PEARL ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322085119",
            "telephone_number": "904-760-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "SCHELLHAMMER",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "904-800-6347"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agape Community Health Center, Inc
• Agape Community Health Center, Inc
• Agape Community Health Center, Inc
• Agape Community Health Center, Inc.
• Agape Community Health Center, Inc.
• Agape Community Health Center, Inc.
• Agape Community Health Center, Inc.
• Agape Community Health Center, Inc.
• Agape Community Health Centers, Inc
• Agape Community Health Mobile Unit

• Federally Qualified Health Center (FQHC) in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Federally Qualified Health Center (FQHC) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.