Provider Demographics
NPI:1932420007
Name:AGAPE HOME CARE, INC.
Entity Type:Organization
Organization Name:AGAPE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:INGA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-755-4633
Mailing Address - Street 1:PO BOX 10097
Mailing Address - Street 2:40 APPLEWAY DR.
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59904-3097
Mailing Address - Country:US
Mailing Address - Phone:406-755-4633
Mailing Address - Fax:406-755-3755
Practice Address - Street 1:40 APPLEWAY DR
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3402
Practice Address - Country:US
Practice Address - Phone:406-755-4633
Practice Address - Fax:406-755-3755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care