Provider Demographics
NPI:1942833967
Name:AGAPE CARE FAMILY HOME #2
Entity Type:Organization
Organization Name:AGAPE CARE FAMILY HOME #2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-686-5841
Mailing Address - Street 1:2014 WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-3832
Mailing Address - Country:US
Mailing Address - Phone:336-686-5841
Mailing Address - Fax:
Practice Address - Street 1:2014 WILLOW RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3832
Practice Address - Country:US
Practice Address - Phone:336-686-5841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AGAPE CARE FAMILY HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home