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General NPI Number Information
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NPI Number | 1326187659
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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 | 02/05/2007
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Last Update Date | 06/12/2012
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Provider Practice Location Address
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Address Line | 1232 N MAIN ST
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City | HIGH POINT
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State | NC
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Zip | 27262-3118
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Country | US
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Telephone | 336-884-1475
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Fax | 336-884-1482
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Provider Business Mailing Address
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Address Line | 1232 NORTH MAIN ST HIGH POINT NC
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City | HIGH POINT
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State | NC
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Zip | 27262
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Country | US
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Telephone | 336-884-1475
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Fax | 336-884-1482
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Authorized Official
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Title or Position | DIRECTOR/CEO
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Name | PROF. UGO CHUKWUMA
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Credential |
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Telephone | 336-884-1475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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