Provider Demographics
NPI:1780699173
Name:AGAPE HEALTH CARE SERVICES INC
Entity type:Organization
Organization Name:AGAPE HEALTH CARE SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:CAFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-245-8000
Mailing Address - Street 1:8523 E 11TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-7963
Mailing Address - Country:US
Mailing Address - Phone:918-245-8000
Mailing Address - Fax:918-245-8001
Practice Address - Street 1:8523 E 11TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-7963
Practice Address - Country:US
Practice Address - Phone:918-245-8000
Practice Address - Fax:918-245-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7798251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK7798OtherHOME CARE
OK200075200AMedicaid
OK7798OtherHOME CARE