Provider Demographics
NPI:1629247614
Name:AGAPE HEALTH MANAGEMENT, INC
Entity Type:Organization
Organization Name:AGAPE HEALTH MANAGEMENT, INC
Other - Org Name:AGAPE ADULT DAY HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONG CHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-354-6767
Mailing Address - Street 1:6349 LINCOLNIA RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-1533
Mailing Address - Country:US
Mailing Address - Phone:703-354-6767
Mailing Address - Fax:703-354-2323
Practice Address - Street 1:6349 LINCOLNIA RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-1533
Practice Address - Country:US
Practice Address - Phone:703-354-6767
Practice Address - Fax:703-354-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAFX.08-051-L155261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0151597918Medicaid