Provider Demographics
NPI:1447686902
Name:AGAPE HOSPICE CARE, INC.
Entity type:Organization
Organization Name:AGAPE HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/COO
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOGOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-806-0855
Mailing Address - Street 1:5989 NW REDFOX DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-2663
Mailing Address - Country:US
Mailing Address - Phone:503-806-0855
Mailing Address - Fax:
Practice Address - Street 1:9900 SW WILSHIRE ST
Practice Address - Street 2:SUITE 170
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5035
Practice Address - Country:US
Practice Address - Phone:503-806-0855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based