Provider Demographics
NPI:1750679361
Name:AGAPE IN HOME CARE, LLC
Entity Type:Organization
Organization Name:AGAPE IN HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIYA
Authorized Official - Middle Name:KATRINA
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-907-0939
Mailing Address - Street 1:36 MONTE CARLO WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-6015
Mailing Address - Country:US
Mailing Address - Phone:540-907-0939
Mailing Address - Fax:
Practice Address - Street 1:36 MONTE CARLO WAY
Practice Address - Street 2:
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-6015
Practice Address - Country:US
Practice Address - Phone:540-907-0939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-16
Last Update Date:2011-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty