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NPI 1417814047

NPI 1417814047 : AGEPRIME CARE LLC : RED OAK, TX

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General NPI Number Information
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    NPI Number           |    1417814047
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    Entity Type          |    Organization 
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    Legal Business Name  |    AGEPRIME CARE LLC 
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Dates
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    Enumeration Date     |    01/06/2026
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    Last Update Date     |    01/06/2026
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Provider Practice Location Address
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    Address Line         |    646 OAK HILL WAY 
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    City                 |    RED OAK
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    State                |    TX
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    Zip                  |    75154-2770
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    Country              |    US
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    Telephone            |    682-445-5382
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    646 OAK HILL WAY 
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    City                 |    RED OAK
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    State                |    TX
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    Zip                  |    75154-2770
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    Country              |    US
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    Telephone            |    682-445-5382
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |     MAYOWA OLADELE AGUNBIADE 
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    Credential           |    
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    Telephone            |    682-445-5382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    253Z00000X
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    Taxonomy Name        |    In Home Supportive Care Agency
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    License Number       |    
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    License Number State |    
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