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General NPI Number Information
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NPI Number | 1356576219
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Entity Type | Organization
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Legal Business Name | AGAPE CARE CENTER
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Dates
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Enumeration Date | 05/21/2009
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 9522 ARROWHEAD TERRACE LN
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City | HUMBLE
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State | TX
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Zip | 77396-3079
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Country | US
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Telephone | 713-454-4929
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Fax |
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Provider Business Mailing Address
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Address Line | 9522 ARROWHEAD TERRACE LN
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City | HUMBLE
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State | TX
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Zip | 77396-3079
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DAVID MONTGOMERY JR.
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Credential |
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Telephone | 713-454-4929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 311Z00000X
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 311ZA0620X
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License Number State | TX
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