Provider Demographics
NPI:1568863157
Name:AGAPE HOSPICE & PALLIATIVE CARE, LLC
Entity Type:Organization
Organization Name:AGAPE HOSPICE & PALLIATIVE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LARISA
Authorized Official - Middle Name:MIHAELA
Authorized Official - Last Name:LOUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-914-7005
Mailing Address - Street 1:10200 SW NIMBUS AVE STE G5
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-4339
Mailing Address - Country:US
Mailing Address - Phone:503-914-7005
Mailing Address - Fax:503-477-6547
Practice Address - Street 1:3711 LOMITA BLVD STE 120
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505
Practice Address - Country:US
Practice Address - Phone:213-234-5534
Practice Address - Fax:213-234-5534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550002355251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherIRS