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General NPI Number Information
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NPI Number | 1821682469
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Entity Type | Organization
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Legal Business Name | L&H AGAPE FAMILY CARE HOMES
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 2014 WILLOW RD
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City | GREENSBORO
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State | NC
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Zip | 27406-3832
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Country | US
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Telephone | 336-574-2734
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Fax | 336-937-9157
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Provider Business Mailing Address
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Address Line | 1200 MOODY ST
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City | GREENSBORO
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State | NC
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Zip | 27401-4217
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Country | US
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Telephone | 336-860-4060
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Fax | 336-937-9157
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | HAZEL FORMAN
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Credential |
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Telephone | 336-860-4060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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