Provider Demographics
NPI:1275861551
Name:AGAPE TOTAL CARE, L.L.C.
Entity Type:Organization
Organization Name:AGAPE TOTAL CARE, L.L.C.
Other - Org Name:AGAPE ADULT DAY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/QMRP
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WALLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-942-5570
Mailing Address - Street 1:9353 HIGHWAY 182
Mailing Address - Street 2:LOT B
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-1204
Mailing Address - Country:US
Mailing Address - Phone:337-942-5535
Mailing Address - Fax:337-942-5078
Practice Address - Street 1:9353 HIGHWAY 182
Practice Address - Street 2:LOT B
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-1204
Practice Address - Country:US
Practice Address - Phone:337-942-5535
Practice Address - Fax:337-942-5078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA68313747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1033384367Medicaid
LA1326223868Medicaid
LA1891979598Medicaid
LA1538343447Medicaid
LA1891979704Medicaid