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NPI 1144552613

NPI 1144552613 : AGAPE HOME HEALTH SERVICES INC. : TROTWOOD, OH

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General NPI Number Information
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    NPI Number           |    1144552613
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    Entity Type          |    Organization 
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    Legal Business Name  |    AGAPE HOME HEALTH SERVICES INC. 
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Dates
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    Enumeration Date     |    02/08/2010
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    Last Update Date     |    02/08/2010
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Provider Practice Location Address
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    Address Line         |    4425 THOMPSON DR 
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    City                 |    TROTWOOD
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    State                |    OH
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    Zip                  |    45416-2237
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    Country              |    US
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    Telephone            |    937-279-9943
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4425 THOMPSON DR 
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    City                 |    TROTWOOD
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    State                |    OH
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    Zip                  |    45416-2237
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    Country              |    US
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    Telephone            |    937-279-9943
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    MS. SHELLANDA MARIE MONTGOMERY 
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    Credential           |    
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    Telephone            |    937-279-9943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    
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    License Number State |    OH
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