Provider Demographics
NPI:1588864227
Name:AGAPE HOMES
Entity type:Organization
Organization Name:AGAPE HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:HANCHETT
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-453-6385
Mailing Address - Street 1:29618 LEGENDS PINE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2025
Mailing Address - Country:US
Mailing Address - Phone:832-453-6385
Mailing Address - Fax:281-350-5980
Practice Address - Street 1:29618 LEGENDS PINE LANE
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386
Practice Address - Country:US
Practice Address - Phone:832-453-6385
Practice Address - Fax:281-350-5980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child