Provider Demographics
NPI:1902616840
Name:AGAPE WELLNESS AND HOME CARE
Entity type:Organization
Organization Name:AGAPE WELLNESS AND HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHARGE NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAYNOLDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:860-271-6481
Mailing Address - Street 1:101 NEWBURY ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-3839
Mailing Address - Country:US
Mailing Address - Phone:860-271-6481
Mailing Address - Fax:
Practice Address - Street 1:101 NEWBURY ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-3839
Practice Address - Country:US
Practice Address - Phone:860-271-6481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care