Provider Demographics
NPI:1982347472
Name:AGAPE BEHAVIORAL CENTER LLC
Entity type:Organization
Organization Name:AGAPE BEHAVIORAL CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:MAVROOKAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-200-4373
Mailing Address - Street 1:1164 E OAKLAND PARK BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-2709
Mailing Address - Country:US
Mailing Address - Phone:754-200-4373
Mailing Address - Fax:
Practice Address - Street 1:5081 NW DUNN RD
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34981-4942
Practice Address - Country:US
Practice Address - Phone:772-362-5651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility