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General NPI Number Information
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NPI Number | 1689651176
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Entity Type | Organization
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Legal Business Name | AGAPE HOME CARE, INC.
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 1004 W FOOTHILL BLVD SUITE 202
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City | UPLAND
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State | CA
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Zip | 91786-3774
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Country | US
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Telephone | 909-949-7666
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Fax | 909-949-7670
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Provider Business Mailing Address
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Address Line | 1004 W FOOTHILL BLVD SUITE 202
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City | UPLAND
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State | CA
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Zip | 91786-3774
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Country | US
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Telephone | 909-949-7666
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Fax | 909-949-7670
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Authorized Official
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Title or Position | CFO
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Name | GERRY LUCAS
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Credential |
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Telephone | 909-949-7666
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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 | CA
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