MEDICARE: AGAPE HOME SERVICES, 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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1427199686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGAPE HOME SERVICES, INC

Provider Business Mailing Address
First Line	:	5821 MINERS POINT CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-7325
Country	:	US
Telephone Number	:	904-768-7258
Fax Number	:

Provider Business Practice Location Address
First Line	:	5821 MINERS POINT CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-7325
Country	:	US
Telephone Number	:	904-768-7258
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. PATRICIA S. WASHINGTON
Credential	:	M.S.ED.
Telephone Number	:	904-768-7258

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	08/22/2020

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