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General NPI Number Information
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NPI Number | 1659680593
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Entity Type | Organization
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Legal Business Name | AGAPE CARE SERVICES, INC,
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Dates
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Enumeration Date | 09/27/2010
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Last Update Date | 09/27/2010
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Provider Practice Location Address
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Address Line | 34 W MAIN ST
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City | MADISON
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State | OH
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Zip | 44057-3126
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Country | US
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Telephone | 440-428-0056
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Fax | 440-428-0079
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Provider Business Mailing Address
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Address Line | 34 W MAIN ST
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City | MADISON
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State | OH
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Zip | 44057-3126
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Country | US
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Telephone | 440-428-0056
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Fax | 440-428-0079
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Authorized Official
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Title or Position | DIRECTOR/PROGRAM MANAGER
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Name | JOSHUA MCCREIGHT
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Credential |
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Telephone | 440-474-3213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 4301786
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License Number State | OH
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