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General NPI Number Information
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NPI Number | 1467608232
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Entity Type | Organization
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Legal Business Name | AGAPE PERSONAL CARE SERVICES, LLC
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Dates
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Enumeration Date | 08/13/2008
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 5917 JONES CREEK RD STE 200A
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City | BATON ROUGE
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State | LA
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Zip | 70817-3000
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Country | US
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Telephone | 225-751-2409
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Fax | 225-751-2466
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Provider Business Mailing Address
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Address Line | PO BOX 77710
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City | BATON ROUGE
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State | LA
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Zip | 70879-7710
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Country | US
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Telephone | 225-751-2049
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Fax | 225-757-2466
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | FELECIA R JACOB-LEWIS
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Credential |
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Telephone | 225-751-2409
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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 | PCA 15083
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License Number State | LA
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