Healthcare Provider Details

I. General information

NPI: 1023860632
Provider Name (Legal Business Name): AGAPE HEARTS HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 E 46TH ST STE 115
INDIANAPOLIS IN
46205-1449
US

IV. Provider business mailing address

5641 WYCKFIELD WAY
INDIANAPOLIS IN
46220-4037
US

V. Phone/Fax

Practice location:
  • Phone: 317-998-5104
  • Fax:
Mailing address:
  • Phone: 317-998-5104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TAMARA SHORT
Title or Position: OWNER/CEO
Credential:
Phone: 317-998-5104