Provider Demographics
NPI:1831660521
Name:AGILE GUARDCARE
Entity Type:Organization
Organization Name:AGILE GUARDCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:FOLASHADE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADELEYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:817-852-5302
Mailing Address - Street 1:916 CROWDER DR
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-3657
Mailing Address - Country:US
Mailing Address - Phone:817-852-5302
Mailing Address - Fax:
Practice Address - Street 1:916 CROWDER DR
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-3657
Practice Address - Country:US
Practice Address - Phone:817-852-5302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No282E00000XHospitalsLong Term Care Hospital
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No385H00000XRespite Care FacilityRespite Care