Provider Demographics
NPI:1265891188
Name:AGAPE CARE COMMUNITY
Entity type:Organization
Organization Name:AGAPE CARE COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:OJUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:ABIAKAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-368-7200
Mailing Address - Street 1:12500 E ILIFF AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1374
Mailing Address - Country:US
Mailing Address - Phone:303-368-7200
Mailing Address - Fax:303-368-7202
Practice Address - Street 1:12500 E ILIFF AVE STE 200
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1374
Practice Address - Country:US
Practice Address - Phone:303-368-7200
Practice Address - Fax:303-368-7202
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AGAPE CARE COMMUNITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-19
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04U711251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO44234244Medicaid