Provider Demographics
NPI:1679704506
Name:AGAPA LLC
Entity type:Organization
Organization Name:AGAPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DABNEY-LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-298-0061
Mailing Address - Street 1:7131 LIBERTY RD
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4575
Mailing Address - Country:US
Mailing Address - Phone:410-298-0060
Mailing Address - Fax:410-298-2411
Practice Address - Street 1:7131 LIBERTY RD
Practice Address - Street 2:SUITE 100A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-4575
Practice Address - Country:US
Practice Address - Phone:410-298-0060
Practice Address - Fax:410-298-2411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health