MEDICARE: AGAPE HEALTHCARE 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	171100000X	Acupuncturist	AC12985	CA

General Provider Information

NPI Number	:	1730570615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGAPE HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	15501 SAN FERNANDO MISSION BLVD
Second Line	:	SUITE 311
City	:	MISSION HILLS
State	:	CA
Zip	:	91345-1359
Country	:	US
Telephone Number	:	818-403-6130
Fax Number	:	818-403-6138

Provider Business Practice Location Address
First Line	:	15501 SAN FERNANDO MISSION BLVD
Second Line	:	SUITE 311
City	:	MISSION HILLS
State	:	CA
Zip	:	91345-1359
Country	:	US
Telephone Number	:	818-403-6130
Fax Number	:	818-403-6138

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISS GRACE LIM
Credential	:	L.AC.
Telephone Number	:	323-369-0316

Provider Enumeration Date	:	02/12/2015
Last Update Date	:	02/12/2015

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