Agape Residential Care, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

AGAPE RESIDENTIAL CARE, LLC

Doing business as

Agape Residential Care

Practice address

1022 Blair Field LN
Fresno, TX 77545-8689

Phone

(979) 388-8848

NPI assigned

Sep 20, 2024

Last updated

Oct 14, 2024By 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

Mrs. Octavia L KennardNPI 1801623483

Title

Ceo/Provider

Phone

(337) 570-8647

Specialties & licenses 1

Addresses

Other names 1

• Agape Residential Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Octavia Latrice Kennard

  • Nurse's Aide
  • Fresno, TX
  • NPI 1801623483
  NPD Authorized official

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1346067436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9444 CULLEN BLVD # 330282",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770513384",
            "telephone_number": "337-570-8647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 BLAIR FIELD LN",
            "city": "FRESNO",
            "state": "TX",
            "postal_code": "775458689",
            "telephone_number": "979-388-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE RESIDENTIAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "KENNARD",
        "authorized_official_first_name": "OCTAVIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/PROVIDER",
        "authorized_official_telephone_number": "337-570-8647",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agape Residential Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Fresno, TX
• Providers in Fresno, TX by specialty
• Adult Care Home Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.