Provider Demographics
NPI:1518714427
Name:G & J AGAPE LOVE AFH
Entity type:Organization
Organization Name:G & J AGAPE LOVE AFH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:W
Authorized Official - Last Name:MUTHEMBA
Authorized Official - Suffix:
Authorized Official - Credentials:PROVIDER
Authorized Official - Phone:206-790-1250
Mailing Address - Street 1:1824 189TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-4132
Mailing Address - Country:US
Mailing Address - Phone:206-790-1250
Mailing Address - Fax:
Practice Address - Street 1:1824 189TH STREET CT E
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-4132
Practice Address - Country:US
Practice Address - Phone:206-790-1250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care