Healthcare Provider Details

I. General information

NPI: 1770519894
Provider Name (Legal Business Name): AGAPE RESPITE CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 EMMENTAL DR
BERNE IN
46711-2072
US

IV. Provider business mailing address

PO BOX 84
BERNE IN
46711-0084
US

V. Phone/Fax

Practice location:
  • Phone: 260-589-3351
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: ROBERTA J LEHMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 260-589-3351