Provider Demographics
NPI:1215100771
Name:AGAPE CARE HOME HEALTH, INC.
Entity type:Organization
Organization Name:AGAPE CARE HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIWANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOPPER-GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-287-3963
Mailing Address - Street 1:712 MANER PLACE CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:336-201-8047
Practice Address - Street 1:712 MANER PLACE CT
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-5027
Practice Address - Country:US
Practice Address - Phone:336-287-3963
Practice Address - Fax:336-201-8047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health