Provider Demographics
NPI:1316595481
Name:AGAPE HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:AGAPE HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALENTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHARMS-MCNEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-563-4904
Mailing Address - Street 1:390 WINDPHER RDG
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-5592
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:390 WINDPHER RDG
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-5592
Practice Address - Country:US
Practice Address - Phone:770-744-0214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No385H00000XRespite Care FacilityRespite Care