MEDICARE: AGAPE FAMILY CAREGIVERS

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	385H00000X	Respite Care

General Provider Information

NPI Number	:	1386895878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGAPE FAMILY CAREGIVERS

Provider Business Mailing Address
First Line	:	633 BURLINGAME ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-1004
Country	:	US
Telephone Number	:	517-579-0574
Fax Number	:	313-826-7864

Provider Business Practice Location Address
First Line	:	633 BURLINGAME ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-1004
Country	:	US
Telephone Number	:	517-579-0574
Fax Number	:	313-826-7864

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. SUSAN YVETTE JONES
Credential	:
Telephone Number	:	866-471-6801

Provider Enumeration Date	:	10/02/2008
Last Update Date	:	10/02/2008

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Directions to “AGAPE FAMILY CAREGIVERS ” Practice Location

Language	Start Address	Practice Location

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