Provider Demographics
NPI:1679221253
Name:AGAPE HOME HELP AGENCY
Entity Type:Organization
Organization Name:AGAPE HOME HELP AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:O
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-635-7491
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:PARKIN
Mailing Address - State:AR
Mailing Address - Zip Code:72373-0002
Mailing Address - Country:US
Mailing Address - Phone:870-635-7491
Mailing Address - Fax:
Practice Address - Street 1:116 LAKE ST
Practice Address - Street 2:
Practice Address - City:PARKIN
Practice Address - State:AR
Practice Address - Zip Code:72373-9098
Practice Address - Country:US
Practice Address - Phone:870-635-7491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385H00000XRespite Care FacilityRespite Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty