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General NPI Number Information
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NPI Number | 1801147764
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Entity Type | Organization
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Legal Business Name | AGAPE CARE, LLC
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Dates
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Enumeration Date | 10/01/2012
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Last Update Date | 10/01/2012
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Provider Practice Location Address
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Address Line | 1441 CANOPY OAKS DR
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City | ORANGE PARK
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State | FL
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Zip | 32065-4298
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Country | US
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Telephone | 904-994-3891
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 CANOPY OAKS DR
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City | ORANGE PARK
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State | FL
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Zip | 32065-4298
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Country | US
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Telephone | 904-994-3891
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Fax |
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Authorized Official
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Title or Position | HEALTHCARE PROVIDER/PRESIDENT
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Name | MRS. SHARON WHITE
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Credential |
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Telephone | 904-994-3891
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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 | 693646696
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License Number State | FL
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