Provider Demographics
NPI:1558752873
Name:AGAPE LOVE HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:AGAPE LOVE HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HEDWING
Authorized Official - Middle Name:NDUM
Authorized Official - Last Name:DEH
Authorized Official - Suffix:
Authorized Official - Credentials:HEALTHCARE ADMINISTR
Authorized Official - Phone:240-715-2412
Mailing Address - Street 1:13908 CASTLE BLVD
Mailing Address - Street 2:103
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4945
Mailing Address - Country:US
Mailing Address - Phone:240-715-2412
Mailing Address - Fax:
Practice Address - Street 1:13908 CASTLE BLVD
Practice Address - Street 2:103
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4945
Practice Address - Country:US
Practice Address - Phone:240-715-2412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care