Provider Demographics
NPI:1427448752
Name:AGAPE PERSONAL CARE AGENCY INC
Entity type:Organization
Organization Name:AGAPE PERSONAL CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SINGLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-461-4782
Mailing Address - Street 1:4701 N 50TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-5134
Mailing Address - Country:US
Mailing Address - Phone:414-461-4782
Mailing Address - Fax:866-440-0779
Practice Address - Street 1:1442 N FARWELL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2996
Practice Address - Country:US
Practice Address - Phone:414-461-4782
Practice Address - Fax:866-440-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WINONATTESTING253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care