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General NPI Number Information
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NPI Number | 1588864227
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Entity Type | Organization
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Legal Business Name | AGAPE HOMES
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 07/20/2007
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Provider Practice Location Address
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Address Line | 29618 LEGENDS PINE LANE
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City | SPRING
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State | TX
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Zip | 77386
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Country | US
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Telephone | 832-453-6385
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Fax | 281-350-5980
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Provider Business Mailing Address
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Address Line | 29618 LEGENDS PINE LN
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City | SPRING
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State | TX
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Zip | 77386-2025
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Country | US
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Telephone | 832-453-6385
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Fax | 281-350-5980
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Authorized Official
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Title or Position | PRESIDENT/PROGRAM DIRECTOR
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Name | MRS. KIMBERLY HANCHETT WALLACE
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Credential |
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Telephone | 832-453-6385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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