Healthcare Provider Details

I. General information

NPI: 1457641532
Provider Name (Legal Business Name): AGAPE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4904 7TH ST NE
WASHINGTON DC
20017-2300
US

IV. Provider business mailing address

4904 7TH ST NE
WASHINGTON DC
20017-2300
US

V. Phone/Fax

Practice location:
  • Phone: 202-525-3305
  • Fax: 202-525-3305
Mailing address:
  • Phone: 202-525-3305
  • Fax: 202-525-3305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberALR-0022
License Number StateDC

VIII. Authorized Official

Name: MS. ANDERLINE OKALA
Title or Position: ADMINISTRATOR
Credential:
Phone: 202-591-9059