AGAPE COMMUNITY HEALTH CENTER, INC. (NPI# 1962867762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962867762 |
| Entity Type | Organization |
| Organization Name | AGAPE COMMUNITY HEALTH CENTER, INC. |
| Practice Address |
120 King St Jacksonville FL 32204-2410 |
| Practice Telephone | 9047604904 |
| Practice Fax Number | 9049304607 |
| Mailing Telephone | 9047604904 |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2020-09-09 |
| Authorized Official Name | MS. MIA L JONES (CEO) |
| Authorized Official Telephone | 9042531069 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
N04000004094 | FL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982069795 | Agape Community Health Center, Inc. | Clinic/Center | 5316 N Pearl St, Jacksonville, FL 32208-5119 | 2015-12-21 |
| 1578928826 | Agape Community Health Center, Inc. | Clinic/Center | 5460 Blanding Blvd, Jacksonville, FL 32244-1957 | 2015-12-30 |
| 1972968402 | Agape Community Health Center, Inc. | Clinic/Center | 3160 Edgewood Ave W, Jacksonville, FL 32209-2245 | 2015-12-29 |
| Street Address |
120 KING ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-2410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295718104 | Christine J Trunk | Dentist | 120 King St, Jacksonville, FL 32204-2410 | 2005-11-23 |
| 1336781772 | Wendy Lynn King | Nurse Practitioner | 120 King St, Jacksonville, FL 32204-2410 | 2019-10-16 |
| 1497269880 | Jau R Evans | Nurse Practitioner | 120 King St, Jacksonville, FL 32204-2410 | 2017-11-22 |
| 1225576499 | Shaunetra Toler | Nurse Practitioner | 120 King St, Jacksonville, FL 32204-2410 | 2017-02-07 |
| 1053863746 | Charles Emerson | Physician Assistant | 120 King St, Jacksonville, FL 32204-2410 | 2016-10-27 |
| 1992154181 | Agape Community Health Center Inc | Pharmacy | 120 King St, Jacksonville, FL 32204-2410 | 2016-06-08 |
| 1447621420 | Judith Hepburn | Nurse Practitioner | 120 King St, Jacksonville, FL 32204-2410 | 2015-10-15 |
| 1043631435 | Shelly Anthony | Dental Hygienist | 120 King St, Jacksonville, FL 32204-2410 | 2014-01-02 |
| 1205013232 | Florida Department of Health | Public Health or Welfare | 120 King St, Mc 75, Jacksonville, FL 32204-2410 | 2008-01-22 |
| 1548440076 | Gwendolyn Ann Merritt | Nurse Practitioner | 120 King St, Jacksonville, FL 32204-2410 | 2007-11-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518469527 | Special Health Resources for Texas, Incorporated | Clinic/Center | 1011 College Street, Jacksonville, TX 75766-3307 | 2018-03-06 |
| 1982069795 | Agape Community Health Center, Inc. | Clinic/Center | 5316 N Pearl St, Jacksonville, FL 32208-5119 | 2015-12-21 |
| 1497010425 | Fl Department of Health | Clinic/Center | 1736 University Blvd S, Jacksonville, FL 32216-8929 | 2012-07-05 |
| 1578892485 | Grandmary's House | Clinic/Center | 4828 Evanston Rd, Jacksonville, FL 32208 | 2009-12-24 |
| 1326668351 | Agape Community Health Center, Inc | Clinic/Center | 6024 Merrill Rd, Jacksonville, FL 32277-3427 | 2020-04-20 |
| 1376178814 | Agape Community Health Center, Inc | Clinic/Center | 1680 Dunn Ave Ste 35, Jacksonville, FL 32218-4744 | 2020-03-05 |
| 1760963516 | Arcare | Clinic/Center | 1400 Braden St Ste 1, Jacksonville, AR 72076-3721 | 2018-08-28 |
| 1649628009 | Board of Trustees of Southern Illinois University | Clinic/Center | 345 W State St, Jacksonville, IL 62650-1879 | 2016-05-26 |
| 1578928826 | Agape Community Health Center, Inc. | Clinic/Center | 5460 Blanding Blvd, Jacksonville, FL 32244-1957 | 2015-12-30 |
| 1245695774 | Agape Community Health Center, Inc | Clinic/Center | 3900 University Blvd S Ste 2, Jacksonville, FL 32216-4331 | 2015-12-29 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.