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General NPI Number Information
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NPI Number | 1568863157
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Entity Type | Organization
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Legal Business Name | AGAPE HOSPICE & PALLIATIVE CARE, LLC
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 08/31/2018
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Provider Practice Location Address
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Address Line | 3711 LOMITA BLVD STE 120
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City | TORRANCE
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State | CA
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Zip | 90505
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Country | US
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Telephone | 213-234-5534
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Fax | 213-234-5534
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Provider Business Mailing Address
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Address Line | 10200 SW NIMBUS AVE STE G5
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City | TIGARD
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State | OR
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Zip | 97223-4339
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Country | US
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Telephone | 503-914-7005
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Fax | 503-477-6547
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Authorized Official
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Title or Position | CEO
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Name | MRS. LARISA MIHAELA LOUKA
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Credential |
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Telephone | 503-914-7005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 550002355
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License Number State | CA
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