Provider Demographics
NPI:1558917864
Name:AGAPE CARE FAMILY HOME
Entity Type:Organization
Organization Name:AGAPE CARE FAMILY HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-686-5841
Mailing Address - Street 1:1801 BRITTON ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-3132
Mailing Address - Country:US
Mailing Address - Phone:336-686-5841
Mailing Address - Fax:
Practice Address - Street 1:1801 BRITTON ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3132
Practice Address - Country:US
Practice Address - Phone:336-686-5841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home