Organization
AGAPE FAMILY CARE HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MALTESE FULLER (PRESIDENT)
(336) 932-1593
Entity
Organization
Contact information
Practice address
120 CARRIAGE LOOP, BURLINGTON, NC 27217-7549
(336) 222-0135
(336) 222-8607
Mailing address
P.O. BOX 5126, BURLINGTON, NC 27216-5126
(336) 222-0135
(336) 222-8607
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FC1-00-143
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805401
—
NC
Enumeration date
03/26/2007
Last updated
02/04/2015
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