Provider Demographics
NPI:1487192910
Name:AGAPE SENIOR CARE SERVICES LLC
Entity Type:Organization
Organization Name:AGAPE SENIOR CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIME ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:RIGINA
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-838-6935
Mailing Address - Street 1:1423 DUNWOODY AVENUE
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-2304
Mailing Address - Country:US
Mailing Address - Phone:240-838-6935
Mailing Address - Fax:240-427-9895
Practice Address - Street 1:1423 DUNWOODY AVENUE
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-2304
Practice Address - Country:US
Practice Address - Phone:240-838-6935
Practice Address - Fax:240-427-9895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health