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General NPI Number Information
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NPI Number | 1326183864
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Entity Type | Organization
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Legal Business Name | AGAPE HOMES INC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1032 W LEE ST
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City | GREENSBORO
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State | NC
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Zip | 27403-2805
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Country | US
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Telephone | 336-389-0096
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Fax | 336-389-0266
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Provider Business Mailing Address
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Address Line | 3214 PINE NEEDLES RD
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City | HIGH POINT
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State | NC
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Zip | 27265-2033
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Country | US
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Telephone | 336-389-0096
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Fax | 336-389-0266
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. HENRY CHUKWUMA
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Credential |
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Telephone | 336-389-0096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | MHL-041-688
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License Number State | NC
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