Provider Demographics
NPI:1497827109
Name:AGAPE HOME HEALTH CARE
Entity Type:Organization
Organization Name:AGAPE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAYLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEADON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-268-2401
Mailing Address - Street 1:540 E 105TH ST
Mailing Address - Street 2:SUITE 305-B
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-4301
Mailing Address - Country:US
Mailing Address - Phone:216-268-2401
Mailing Address - Fax:216-268-2873
Practice Address - Street 1:540 E 105TH ST
Practice Address - Street 2:SUITE 305-B
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-4301
Practice Address - Country:US
Practice Address - Phone:216-268-2401
Practice Address - Fax:216-268-2873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1462665251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health