Provider Demographics
NPI:1194210906
Name:AGAPE GEM CARE LLC
Entity Type:Organization
Organization Name:AGAPE GEM CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLERMONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-300-1747
Mailing Address - Street 1:2945 E BAY DR STE A
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-2607
Mailing Address - Country:US
Mailing Address - Phone:727-300-1747
Mailing Address - Fax:727-490-7076
Practice Address - Street 1:2945 E BAY DR STE A
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771
Practice Address - Country:US
Practice Address - Phone:727-300-1747
Practice Address - Fax:727-490-7076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care