Agape Comprehensive Outpatient Rehabilitation Facility, Inc.

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

AGAPE COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY, INC.

Doing business as

Agape Rehabilitation Institute

Practice address

2835 Hollywood Ave
Shreveport, LA 71108-3848

Phone

(318) 631-4181

Fax

(318) 525-0422

NPI assigned

Mar 15, 2009

Last updated

Mar 15, 2009By 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. Keith Robinson

Title

President

Phone

(318) 572-0795

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Agape Rehabilitation Institute Doing business as

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

{
    "created_epoch": "1237075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237075200000",
    "number": "1225279656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 HOLLYWOOD AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711083848",
            "telephone_number": "318-631-4181",
            "fax_number": "318-525-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 HOLLYWOOD AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711083848",
            "telephone_number": "318-631-4181",
            "fax_number": "318-525-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-15",
        "last_updated": "2009-03-15",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-572-0795",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1471933",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agape Rehabilitation Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Comprehensive Outpatient Rehabilitation Facility (CORF) in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2009; 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.