MEDICARE: AGAPE HOMECARE PLUS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	688075401	FL
2	251E00000X	Home Health Agency	688075496	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154481356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGAPE HOMECARE PLUS INC.

Provider Business Mailing Address
First Line	:	2142 FIGARO LN
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-2926
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2142 FIGARO LN
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-2926
Country	:	US
Telephone Number	:	904-502-2666
Fax Number	:

Authorized Official
Title or Position	:	AGENCY DIRECTOR
Name	:	MAERINE RAYNER
Credential	:
Telephone Number	:	904-502-2666

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	11/18/2014

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Directions to “AGAPE HOMECARE PLUS INC. ” Practice Location

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