10D2297696 CLIA NUMBER - AGAPE HEALTH AND WELLNESS CENTER

Laboratory Demographics

CLIA Number: 10D2297696

Facility Name: AGAPE HEALTH AND WELLNESS CENTER

Facility Address:
6138 KENNERLY ROAD, SUITE 110 & 150
JACKSONVILLE, FL
ZIP 32216
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Facility Phone Number: 904 619-6715

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1386223469

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	10D2297696
LAB Type	Community Clinic
Facility Name	AGAPE HEALTH AND WELLNESS CENTER
Street	6138 KENNERLY ROAD, SUITE 110 & 150
City	JACKSONVILLE
State	FL
ZIP	32216
Phone	904 619-6715
CertificateType	4
CertificateEffectiveDate	1/19/2024
CertificateExpirationDate	1/18/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024