Provider Demographics
NPI:1730570615
Name:AGAPE HEALTHCARE INC.
Entity type:Organization
Organization Name:AGAPE HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:323-369-0316
Mailing Address - Street 1:15501 SAN FERNANDO MISSION BLVD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1359
Mailing Address - Country:US
Mailing Address - Phone:818-403-6130
Mailing Address - Fax:818-403-6138
Practice Address - Street 1:15501 SAN FERNANDO MISSION BLVD
Practice Address - Street 2:SUITE 311
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1359
Practice Address - Country:US
Practice Address - Phone:818-403-6130
Practice Address - Fax:818-403-6138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12985171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty