Agape Home Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

AGAPE HOME CARE, INC.

Practice address

1004 W Foothill Blvd
Suite 202
Upland, CA 91786-3774

Phone

(909) 949-7666

Fax

(909) 949-7670

NPI assigned

Dec 27, 2005

Last updated

Dec 20, 2007By 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

Gerry Lucas

Title

Cfo

Phone

(909) 949-7666

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689651176. Details of each certification follow.

• CCN 557559 Home health agency · Active · Details

Home health agency certification: CCN 557559

Legal name

AGAPE HOME CARE, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 30, 1995

Last certification

Jan 12, 2018

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jul 24, 1996 in CA

Enrollment address

99 N San Antonio Ave
Ste 360
Upland, CA 91786-4579

Listed as

Agape Home CareCCN 557559 · All quality measures

Ownership

Proprietary

Certified

May 30, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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.

• Hedy Cecilia Loa, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Ontario, CA
  • NPI 1093720666
  NPD (past)

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1689651176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 W FOOTHILL BLVD",
            "address_2": "SUITE 202",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863774",
            "telephone_number": "909-949-7666",
            "fax_number": "909-949-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 W FOOTHILL BLVD",
            "address_2": "SUITE 202",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863774",
            "telephone_number": "909-949-7666",
            "fax_number": "909-949-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "GERRY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "909-949-7666"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUMB",
            "identifier": "ZZZ59686Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA57559G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Upland, CA
• Providers in Upland, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.