NPIMap

Organization Active NPI

Agape Family Care Homes, LLC

  • Assisted Living Facility (Mental Illness)
  • Raleigh, NC
National Provider Identifier
1699895540
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
MHL-092-622 Issued in NC
Legal business name
AGAPE FAMILY CARE HOMES, LLC
Practice address
2336 Ravenhill Dr
Raleigh, NC 27615-7531
Phone
(919) 790-1016
Fax
(919) 876-9252
NPI assigned
Apr 1, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Ezuma Asi, RN
Title
Administrator
Phone
(919) 605-6177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X MHL-092-622 NC Primary

Addresses

Primary practice location

2336 Ravenhill Dr
Raleigh, NC 27615-7531

Mailing address

2336 Ravenhill Dr
PO Box 14963
Raleigh, NC 27615-7531
Phone (919) 790-1016

Other identifiers 1

IdentifierTypeStateIssuer
7805229MedicaidNC

Other names 1

  • agape healthcare services Other name

National Provider Directory

National Provider Directory
Tax ID family
Agape Family Care Homes LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1175385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699895540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2336 RAVENHILL DR",
            "address_2": "PO BOX 14963",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276157531",
            "telephone_number": "919-790-1016",
            "fax_number": "919-876-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2336 RAVENHILL DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276157531",
            "telephone_number": "919-790-1016",
            "fax_number": "919-876-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE FAMILY CARE HOMES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ASI",
        "authorized_official_first_name": "EZUMA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-605-6177",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NC",
            "license": "MHL-092-622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805229",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "agape healthcare services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.