Provider Demographics
NPI:1356627087
Name:AGAPE HEATH CARE LLC
Entity Type:Organization
Organization Name:AGAPE HEATH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:KASSI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:240-898-8900
Mailing Address - Street 1:15 PRESTBURY SQ STE 2
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2608
Mailing Address - Country:US
Mailing Address - Phone:302-533-6121
Mailing Address - Fax:
Practice Address - Street 1:15 PRESTBURY SQ STE 2
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2608
Practice Address - Country:US
Practice Address - Phone:302-533-6121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEHHAS-050251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health