Healthcare Provider Details

I. General information

NPI: 1033384367
Provider Name (Legal Business Name): AGAPE TOTAL CARE, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9353 HIGHWAY 182 LOT B
OPELOUSAS LA
70570-1204
US

IV. Provider business mailing address

9353 HIGHWAY 182 LOT B
OPELOUSAS LA
70570-1204
US

V. Phone/Fax

Practice location:
  • Phone: 337-942-5570
  • Fax: 337-942-5078
Mailing address:
  • Phone: 337-942-5570
  • Fax: 337-942-5078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number6831
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number6831
License Number StateLA

VIII. Authorized Official

Name: MRS. ROSE MARIE WALLS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 337-942-5570