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General NPI Number Information
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NPI Number | 1629247614
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Entity Type | Organization
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Legal Business Name | AGAPE HEALTH MANAGEMENT, INC
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 05/31/2016
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Provider Practice Location Address
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Address Line | 6349 LINCOLNIA RD
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City | ALEXANDRIA
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State | VA
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Zip | 22312-1533
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Country | US
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Telephone | 703-354-6767
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Fax | 703-354-2323
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Provider Business Mailing Address
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Address Line | 6349 LINCOLNIA RD
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City | ALEXANDRIA
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State | VA
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Zip | 22312-1533
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Country | US
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Telephone | 703-354-6767
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Fax | 703-354-2323
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONG CHUL CHOI
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Credential |
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Telephone | 703-354-6767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | FX.08-051-L155
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License Number State | VA
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