Provider Demographics
NPI:1245502038
Name:AGAPE SPECIALTY CARE
Entity type:Organization
Organization Name:AGAPE SPECIALTY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:RAUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-389-2022
Mailing Address - Street 1:3613 W MACARTHUR BLVD STE 607
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6846
Mailing Address - Country:US
Mailing Address - Phone:714-389-2022
Mailing Address - Fax:714-389-2023
Practice Address - Street 1:3613 W MACARTHUR BLVD STE 607
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6846
Practice Address - Country:US
Practice Address - Phone:714-389-2022
Practice Address - Fax:714-389-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care