Provider Demographics
NPI:1932810462
Name:AGAPE PSYCHIATRY HEALTHCARE SERVICES
Entity type:Organization
Organization Name:AGAPE PSYCHIATRY HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:OLUWAFUNMIKE
Authorized Official - Last Name:ADEBUSOYE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP, FNP, BC
Authorized Official - Phone:240-645-3390
Mailing Address - Street 1:2801 CASTLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-0340
Mailing Address - Country:US
Mailing Address - Phone:240-645-3390
Mailing Address - Fax:
Practice Address - Street 1:2801 CASTLE CREEK DRIVE
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068
Practice Address - Country:US
Practice Address - Phone:469-456-9907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty