Provider Demographics
NPI:1649099987
Name:AGAPE CARE HOMES
Entity type:Organization
Organization Name:AGAPE CARE HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VENICE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-252-9971
Mailing Address - Street 1:8120 FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-2402
Mailing Address - Country:US
Mailing Address - Phone:267-252-9971
Mailing Address - Fax:
Practice Address - Street 1:128 E GARRISON BLVD STE D
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0421
Practice Address - Country:US
Practice Address - Phone:267-252-9997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No174200000XOther Service ProvidersMeals
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No177F00000XOther Service ProvidersLodging
No251300000XAgenciesLocal Education Agency (LEA)
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251K00000XAgenciesPublic Health or Welfare
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health
No332U00000XSuppliersHome Delivered Meals
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care