Provider Demographics
NPI:1598472011
Name:AGAPE COMMUNITY SERVICES LLC
Entity Type:Organization
Organization Name:AGAPE COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORLUMKPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-340-7098
Mailing Address - Street 1:1205 S CRISSEY RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-8514
Mailing Address - Country:US
Mailing Address - Phone:419-340-7098
Mailing Address - Fax:
Practice Address - Street 1:1205 S CRISSEY RD
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-8514
Practice Address - Country:US
Practice Address - Phone:419-340-7098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle