Agape Family Home, LLC

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

103027299 Issued in PA

Legal business name

AGAPE FAMILY HOME, LLC

Practice address

2604 Johnson Rd
Upper Chichester, PA 19061-3523

Phone

(267) 408-2202

NPI assigned

Feb 5, 2017

Organization subpart

No

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

Authorized official

Name

Racheal Christiana Bundor, LPNNPI 1174984157

Title

Owner

Phone

(267) 408-2202

Specialties & licenses 15

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Racheal Bundor, CEO

  • Day Training/Habilitation Specialist
  • Upper Chichester, PA
  • NPI 1174984157
  NPD (past) Authorized official

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

{
    "created_epoch": "1486252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1528506086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 JOHNSON RD",
            "city": "UPPER CHICHESTER",
            "state": "PA",
            "postal_code": "190613523",
            "telephone_number": "267-408-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 JOHNSON RD",
            "city": "UPPER CHICHESTER",
            "state": "PA",
            "postal_code": "190613523",
            "telephone_number": "267-408-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE FAMILY HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-05",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "BUNDOR",
        "authorized_official_first_name": "RACHEAL",
        "authorized_official_middle_name": "CHRISTIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-408-2202",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Case Management",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "163WG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Gerontology",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "163WI0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Infection Control",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "163WX1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Ostomy Care",
            "state": "PA",
            "license": "103027299",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "103027299",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "PA",
            "license": "103027299",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Upper Chichester, PA
• Providers in Upper Chichester, PA by specialty
• Licensed Practical Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.