Healthcare Provider Details

I. General information

NPI: 1568863157
Provider Name (Legal Business Name): AGAPE HOSPICE & PALLIATIVE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 08/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 LOMITA BLVD STE 120
TORRANCE CA
90505
US

IV. Provider business mailing address

10200 SW NIMBUS AVE STE G5
TIGARD OR
97223-4339
US

V. Phone/Fax

Practice location:
  • Phone: 213-234-5534
  • Fax: 213-234-5534
Mailing address:
  • Phone: 503-914-7005
  • Fax: 503-477-6547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number550002355
License Number StateCA

VIII. Authorized Official

Name: MRS. LARISA MIHAELA LOUKA
Title or Position: CEO
Credential:
Phone: 503-914-7005