Provider Demographics
NPI:1417446360
Name:AGAPE SENIORS HOME CARE, LLC
Entity Type:Organization
Organization Name:AGAPE SENIORS HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MISKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-748-0171
Mailing Address - Street 1:2620 S PARKER RD STE 280
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1637
Mailing Address - Country:US
Mailing Address - Phone:720-748-0171
Mailing Address - Fax:720-748-0172
Practice Address - Street 1:2620 S PARKER RD STE 280
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1637
Practice Address - Country:US
Practice Address - Phone:720-748-0171
Practice Address - Fax:720-748-0172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
COO4Q275253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO=========Medicaid