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General NPI Number Information
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NPI Number | 1528578697
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Entity Type | Organization
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Legal Business Name | AGAPE HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 10/03/2017
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 7629 WILLIAMSON RD STE 4B
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City | ROANOKE
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State | VA
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Zip | 24019-4371
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Country | US
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Telephone | 540-595-9215
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Fax | 540-266-7155
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Provider Business Mailing Address
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Address Line | 7629 WILLIAMSON RD STE 4B
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City | ROANOKE
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State | VA
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Zip | 24019-4371
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Country | US
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Telephone | 540-595-9215
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Fax | 540-266-7155
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Authorized Official
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Title or Position | OWNER
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Name | MARQUETTA JONES
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Credential |
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Telephone | 540-595-9215
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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 | 1401055447
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License Number State | VA
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