NPIMap

Organization Active NPI

Agape Recovery Center, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Burlington, WI
National Provider Identifier
1962620013
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1022 Issued in WI
Legal business name
AGAPE RECOVERY CENTER, INC
Practice address
201 N. Pine Street
Burlington, WI 53105-1918
Phone
(262) 767-0441
Fax
(262) 767-9072
NPI assigned
Apr 23, 2007
Last updated
Mar 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Authorized official

Name
Ms. Patricia Ann Gramke
Title
Director
Phone
(262) 767-0441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1022 WI Primary

Addresses

Primary practice location

201 N. Pine Street
Burlington, WI 53105-1918

Mailing address

201 N. Pine Street
Burlington, WI 53105-1918
Phone (262) 767-0441

National Provider Directory

National Provider Directory

Locations

201 N Pine St
Burlington, WI 53105
Phone (262) 767-0441

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1962620013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N. PINE STREET",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051918",
            "telephone_number": "262-767-0441",
            "fax_number": "262-767-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N. PINE STREET",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051918",
            "telephone_number": "262-767-0441",
            "fax_number": "262-767-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE RECOVERY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "GRAMKE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "262-767-0441",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "1022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.