Provider Demographics
NPI:1205387032
Name:AGAPE CARE
Entity Type:Organization
Organization Name:AGAPE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NORRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERMON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:757-440-3862
Mailing Address - Street 1:6406 AVON RD
Mailing Address - Street 2:# 2
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23513-3304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6406 AVON RD
Practice Address - Street 2:# 2
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513-3304
Practice Address - Country:US
Practice Address - Phone:757-440-3862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities