Provider Demographics
NPI:1679826549
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:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:MARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-260-0937
Mailing Address - Street 1:5211 N SALIDA DEL SOL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5411
Mailing Address - Country:US
Mailing Address - Phone:520-615-4751
Mailing Address - Fax:520-577-0863
Practice Address - Street 1:2990 N SWAN ROAD
Practice Address - Street 2:SUITE 227
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712
Practice Address - Country:US
Practice Address - Phone:520-664-8624
Practice Address - Fax:520-615-7802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based