Agape Behavioral Center

Key facts

NPI

1972946804

Entity type

Organization (NPI type 2)

Primary specialty

Clinical Child & Adolescent Psychologist 103TC2200X

Legal business name

AGAPE BEHAVIORAL CENTER

Practice address

3620 N Rancho Dr
Ste. 103
Las Vegas, NV 89130-3155

Phone

(702) 656-5683

NPI assigned

Apr 10, 2013

Organization subpart

No

Authorized official

Name

Mr. Aveeon Noel Williams

Title

Basic Skills Trainer

Phone

(702) 372-8641

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 10, 2013.

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1972946804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3985 E CHEYENNE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891153212",
            "telephone_number": "702-372-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 N RANCHO DR",
            "address_2": "STE. 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303155",
            "telephone_number": "702-656-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE BEHAVIORAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-04-10",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "AVEEON",
        "authorized_official_middle_name": "NOEL",
        "authorized_official_title_or_position": "BASIC SKILLS TRAINER",
        "authorized_official_telephone_number": "702-372-8641",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

• Mary Jo R Aganad, RN
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• Agape Behavioral Center
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• Agape BHFS LLC

All providers in Las Vegas, NV · Clinical Child & Adolescent Psychologist in Nevada