Provider Demographics
NPI:1528578697
Name:AGAPE HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:AGAPE HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARQUETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-595-9215
Mailing Address - Street 1:7629 WILLIAMSON RD STE 4B
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-4371
Mailing Address - Country:US
Mailing Address - Phone:540-595-9215
Mailing Address - Fax:540-266-7155
Practice Address - Street 1:7629 WILLIAMSON RD STE 4B
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-4371
Practice Address - Country:US
Practice Address - Phone:540-595-9215
Practice Address - Fax:540-266-7155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401055447251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health