Provider Demographics
NPI:1720463466
Name:AGAPE PALLIATIVE CARE, LLC
Entity Type:Organization
Organization Name:AGAPE PALLIATIVE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-904-1345
Mailing Address - Street 1:2980 N SWAN RD
Mailing Address - Street 2:STE 225
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6024
Mailing Address - Country:US
Mailing Address - Phone:520-904-1345
Mailing Address - Fax:520-207-6507
Practice Address - Street 1:2980 N SWAN RD
Practice Address - Street 2:STE 225
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6024
Practice Address - Country:US
Practice Address - Phone:520-904-1345
Practice Address - Fax:520-207-6507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty