Provider Demographics
NPI:1114575008
Name:AGAPE'S LOVE
Entity Type:Organization
Organization Name:AGAPE'S LOVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-824-8352
Mailing Address - Street 1:16682 N WEST POINT PKWY APT 123
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-4056
Mailing Address - Country:US
Mailing Address - Phone:602-824-8352
Mailing Address - Fax:602-325-0339
Practice Address - Street 1:16682 N WEST POINT PKWY APT 123
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-4056
Practice Address - Country:US
Practice Address - Phone:602-824-8352
Practice Address - Fax:602-325-0339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness