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General NPI Number Information
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NPI Number | 1215100771
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Entity Type | Organization
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Legal Business Name | AGAPE CARE HOME HEALTH, INC.
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Dates
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Enumeration Date | 04/04/2008
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Last Update Date | 04/04/2008
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Provider Practice Location Address
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Address Line | 712 MANER PLACE CT
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City | WINSTON SALEM
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State | NC
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Zip | 27103-5027
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Country | US
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Telephone | 336-287-3963
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Fax | 336-201-8047
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Provider Business Mailing Address
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Address Line | 712 MANER PLACE CT
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City | WINSTON SALEM
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State | NC
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Zip | 27103-5027
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Country | US
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Telephone |
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Fax | 336-201-8047
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Authorized Official
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Title or Position | CEO
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Name | TIWANA M HOPPER-GOULD
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Credential |
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Telephone | 336-287-3963
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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 |
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