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General NPI Number Information
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NPI Number | 1689107567
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Entity Type | Organization
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Legal Business Name | AGAPE IN MOTION
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Dates
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Enumeration Date | 04/06/2017
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Last Update Date | 04/06/2017
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Provider Practice Location Address
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Address Line | 5227 DELMAR BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1027
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Country | US
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Telephone | 314-361-2727
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Fax | 314-361-3070
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Provider Business Mailing Address
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Address Line | PO BOX 300097
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City | SAINT LOUIS
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State | MO
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Zip | 63130-0366
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Country | US
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Telephone | 314-361-2727
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Fax | 314-361-3070
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Authorized Official
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Title or Position | CEO
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Name | MRS. CHARLA G TERRY
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Credential | MBA
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Telephone | 314-361-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MO
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