Rudy'S Agape House, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

12857 Issued in FL

Legal business name

RUDY'S AGAPE HOUSE, LLC

Practice address

2104 55TH Ave W
Bradenton, FL 34207-3240

Phone

(941) 755-0225

Fax

(941) 460-4304

NPI assigned

Aug 18, 2016

Organization subpart

No

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

Authorized official

Name

Nancy E Cushman

Title

Owner

Phone

(941) 756-0200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rudy's Agape House II Doing business as

Tax ID family

Rudy'S Agape House LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Rudy'S Agape House, LLC

  • Assisted Living Facility
  • Bradenton, FL
  • NPI 1841568961
  NPD tax ID
• Rudy'S Agape House, LLC

  • Adult Day Care Clinic/Center
  • Bradenton, FL
  • NPI 1922421270
  NPD tax ID

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1114472263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5426 18TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342073305",
            "telephone_number": "941-756-0200",
            "fax_number": "941-460-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 55TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342073240",
            "telephone_number": "941-755-0225",
            "fax_number": "941-460-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUDY'S AGAPE HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "CUSHMAN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-756-0200"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "12857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004296700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rudy's Agape House II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas G Rubino, DDS MS
• Elsy Rucker, M.D.
• George Bino Rucker, M.D.
• Christine Louise Rudkin, CPNP
• Sharon Denise Rudolph, NP
• Rudy'S Agape House, LLC
• Rudy'S Agape House, LLC
• Prathibha Rugmini Pillai, BDS
• Tiffany Ruiz
• Mary Lynn Rule, LMHC

• Assisted Living Facility in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.