Provider Demographics
NPI:1336344043
Name:AGAPETOTAL HEALTHCARE SYSTEMS, PC
Entity Type:Organization
Organization Name:AGAPETOTAL HEALTHCARE SYSTEMS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:NKEM
Authorized Official - Last Name:OKECHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:517-702-9880
Mailing Address - Street 1:809 CENTER ST
Mailing Address - Street 2:SUITE 6B
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48906-5258
Mailing Address - Country:US
Mailing Address - Phone:517-702-9880
Mailing Address - Fax:517-702-9771
Practice Address - Street 1:809 CENTER ST
Practice Address - Street 2:SUITE 6B
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-5258
Practice Address - Country:US
Practice Address - Phone:517-702-9880
Practice Address - Fax:517-702-9771
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AGAPETOTAL HEALTHCARE SYSTEMS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-21
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704256440163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty