Provider Demographics
NPI:1063224582
Name:AGAPE MENTAL HEALTH
Entity type:Organization
Organization Name:AGAPE MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IVANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANINOCENCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-475-1485
Mailing Address - Street 1:265 CHELMSFORD ST STE 7
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-2335
Mailing Address - Country:US
Mailing Address - Phone:603-475-1485
Mailing Address - Fax:
Practice Address - Street 1:1030 SKYLINE DRIVE
Practice Address - Street 2:UNIT 21
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826
Practice Address - Country:US
Practice Address - Phone:603-475-1485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)