Provider Demographics
NPI:1770826679
Name:AGAPE HEALTH MANAGEMENT INC
Entity Type:Organization
Organization Name:AGAPE HEALTH MANAGEMENT INC
Other - Org Name:AGAPE HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DONG
Authorized Official - Middle Name:CHUL
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:2013-03-29
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0168660329Medicaid
VA0168595756Medicaid