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General NPI Number Information
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NPI Number | 1639634512
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Entity Type | Organization
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Legal Business Name | AGAPE LOVE INTERNATIONAL FOUNDATION, INC
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Dates
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Enumeration Date | 02/05/2019
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 736 WILSON RD
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City | HUMBLE
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State | TX
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Zip | 77338-5041
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Country | US
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Telephone | 354-254-4665
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Fax | 346-345-2543
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Provider Business Mailing Address
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Address Line | 736 WILSON RD
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City | HUMBLE
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State | TX
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Zip | 77338-5041
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Country | US
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Telephone | 346-254-4665
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Fax | 346-345-2543
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Authorized Official
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Title or Position | OWNER
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Name | TYSHA DETREESE JONES
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Credential |
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Telephone | 346-254-4665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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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 | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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