Provider Demographics
NPI:1114361524
Name:AGAPE LOVE HOME CARE
Entity Type:Organization
Organization Name:AGAPE LOVE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:J
Authorized Official - Last Name:FELTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:707-803-2469
Mailing Address - Street 1:1652 W TEXAS ST STE 254
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-5952
Mailing Address - Country:US
Mailing Address - Phone:707-205-1205
Mailing Address - Fax:
Practice Address - Street 1:1652 W TEXAS ST STE 254
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-5952
Practice Address - Country:US
Practice Address - Phone:707-205-1205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care