| Agape Recovery Center, Pllc | |
|
8338 Nc Highway 39 S Henderson NC 27537-7132 | |
| (919) 538-5459 | |
| Not Available |
| Full Name | Agape Recovery Center, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 8338 Nc Highway 39 S, Henderson, North Carolina |
| Authorized Official Name and Position | Evangeline D. Matthews (OWNER/THERAPIST) |
| Authorized Official Contact | 9195385459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Recovery Center, Pllc 8338 Nc Highway 39 S Henderson NC 27537-7132 Ph: (919) 538-5459 | Agape Recovery Center, Pllc 8338 Nc Highway 39 S Henderson NC 27537-7132 Ph: (919) 538-5459 |
| NPI Number | 1669833760 |
|---|---|
| Provider Enumeration Date | 03/16/2016 |
| Last Update Date | 12/18/2023 |
| Certification Date | 12/18/2023 |
| Medicare PECOS PAC ID | 4789944570 |
|---|---|
| Medicare Enrollment ID | O20180216001821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669833760 | NPI | - | NPPES |
| C009362 | Other | NC | LCSW LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C009632 (North Carolina) | Primary |
| Provider Name | Evangeline D Matthews |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659520062 PECOS PAC ID: 9335449693 Enrollment ID: I20151118002896 |
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