Agape Congregate Living, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

AGAPE CONGREGATE LIVING, LLC

Practice address

302 Fairway LN
Placentia, CA 92870-4442

Phone

(657) 275-9127

Fax

(714) 982-3360

NPI assigned

Feb 21, 2015

Last updated

Sep 25, 2016By 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

Mr. Joseph Alvarez

Title

Partner/Administrator

Phone

(949) 394-8707

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

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

{
    "created_epoch": "1424476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474761600000",
    "number": "1023400538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 FAIRWAY LN",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928704442",
            "telephone_number": "657-275-9127",
            "fax_number": "714-982-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 FAIRWAY LN",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928704442",
            "telephone_number": "657-275-9127",
            "fax_number": "714-982-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE CONGREGATE LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-21",
        "last_updated": "2016-09-25",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PARTNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "949-394-8707",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05D2117482",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.