Provider Demographics
NPI:1851523286
Name:AGAPE HOME HEALTHCARE
Entity Type:Organization
Organization Name:AGAPE HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:H
Authorized Official - Last Name:FOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-808-8670
Mailing Address - Street 1:5703 MILL VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-4056
Mailing Address - Country:US
Mailing Address - Phone:707-808-8670
Mailing Address - Fax:
Practice Address - Street 1:5703 MILL VIEW WAY
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-4056
Practice Address - Country:US
Practice Address - Phone:707-808-8670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0028885775251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health