Provider Demographics
NPI:1326187659
Name:AGAPE HOMES INC.
Entity Type:Organization
Organization Name:AGAPE HOMES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:PROF
Authorized Official - First Name:UGO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUKWUMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-884-1475
Mailing Address - Street 1:1232 NORTH MAIN ST HIGH POINT NC
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262
Mailing Address - Country:US
Mailing Address - Phone:336-884-1475
Mailing Address - Fax:336-884-1482
Practice Address - Street 1:1232 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3118
Practice Address - Country:US
Practice Address - Phone:336-884-1475
Practice Address - Fax:336-884-1482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X, 251S00000X
NCMHL-041-688322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC041688OtherMENTAL HEALTH