Provider Demographics
NPI:1164041760
Name:AAGAPE HOME CARE LLC
Entity Type:Organization
Organization Name:AAGAPE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:
Authorized Official - Last Name:NALLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-281-2255
Mailing Address - Street 1:625 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-5109
Mailing Address - Country:US
Mailing Address - Phone:219-281-2255
Mailing Address - Fax:888-244-6065
Practice Address - Street 1:625 LAKE ST
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-5109
Practice Address - Country:US
Practice Address - Phone:219-281-2255
Practice Address - Fax:888-244-6065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care