Healthcare Provider Details

I. General information

NPI: 1962317909
Provider Name (Legal Business Name): AGAPE HOME NURSING CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 CRANSTON ST
CRANSTON RI
02920-6758
US

IV. Provider business mailing address

1370 CRANSTON ST
CRANSTON RI
02920-6758
US

V. Phone/Fax

Practice location:
  • Phone: 401-591-7865
  • Fax: 401-591-7865
Mailing address:
  • Phone: 401-591-7865
  • Fax: 401-591-7865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARILUZ MERCEDES
Title or Position: ADMINISTRATOR
Credential:
Phone: 401-591-7865