MEDICARE: AGAPE PERSONAL CARE AGENCY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	NONATTESTING	WI

General Provider Information

NPI Number	:	1427448752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGAPE PERSONAL CARE AGENCY INC

Provider Business Mailing Address
First Line	:	4701 N 50TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-5134
Country	:	US
Telephone Number	:	414-461-4782
Fax Number	:	866-440-0779

Provider Business Practice Location Address
First Line	:	1442 N FARWELL AVE
Second Line	:	SUITE 300
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-2996
Country	:	US
Telephone Number	:	414-461-4782
Fax Number	:	866-440-0779

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DORIS ANN SINGLETON
Credential	:
Telephone Number	:	414-461-4782

Provider Enumeration Date	:	01/26/2015
Last Update Date	:	01/26/2015

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