Agape Healthcare Systems Corp

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

HC2914 Issued in NC

Legal business name

AGAPE HEALTHCARE SYSTEMS CORP

Practice address

1015 Roanoke Ave
Roanoke Rapids, NC 27870-3722

Phone

(252) 537-2473

Fax

(888) 315-1326

NPI assigned

Oct 3, 2006

Last updated

Apr 6, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Latisha Holt

Title

Owner

Phone

(252) 537-2473

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1265526016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 ROANOKE AVE",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703722",
            "telephone_number": "252-537-2473",
            "fax_number": "888-315-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 ROANOKE AVE",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703722",
            "telephone_number": "252-537-2473",
            "fax_number": "888-315-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE HEALTHCARE SYSTEMS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "LATISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-537-2473"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NC",
            "license": "HC2914",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NC",
            "license": "LH00422",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601634",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.