Organization
AGAPE HOME CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERRY LUCAS (CFO)
(909) 949-7666
Entity
Organization
Contact information
Practice address
1004 W FOOTHILL BLVD, SUITE 202, UPLAND, CA 91786-3774
(909) 949-7666
(909) 949-7670
Mailing address
1004 W FOOTHILL BLVD, SUITE 202, UPLAND, CA 91786-3774
(909) 949-7666
(909) 949-7670
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA57559G
—
CA
01
—
ZZZ59686Z
BLUE SHIELD PROVIDER NUMB
CA
Enumeration date
12/27/2005
Last updated
12/20/2007
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