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General NPI Number Information
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NPI Number | 1477621878
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Entity Type | Organization
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Legal Business Name | AGAPE FAMILY CARE HOMES, LLC.
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 7208 VIXEN CT
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City | RALEIGH
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State | NC
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Zip | 27616-5284
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Country | US
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Telephone | 919-872-5999
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Fax | 919-876-9252
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Provider Business Mailing Address
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Address Line | PO BOX 14963 7208 VIXEN CT.
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City | RALEIGH
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State | NC
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Zip | 27620-4963
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Country | US
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Telephone | 919-872-5999
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Fax | 919-876-9252
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. EZUMA ASI
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Credential | RN
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Telephone | 919-605-6177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HC2274
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | MHL-092-520
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | MHL-092-539
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | MHL-092-622
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License Number State | NC
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