Organization
AGAPE FAMILY CARE HOMES, LLC
Active
Other names
agape healthcare services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EZUMA ASI RN (ADMINISTRATOR)
(919) 605-6177
Entity
Organization
Contact information
Practice address
2336 RAVENHILL DR, RALEIGH, NC 27615-7531
(919) 790-1016
(919) 876-9252
Mailing address
2336 RAVENHILL DR, PO BOX 14963, RALEIGH, NC 27615-7531
(919) 790-1016
(919) 876-9252
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
MHL-092-622
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805229
—
NC
Enumeration date
04/01/2007
Last updated
08/22/2020
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