Agape Living LLC

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

121-03-020-1 Issued in GA

Legal business name

AGAPE LIVING LLC

Practice address

1840 Phinizy Rd
Augusta, GA 30906-5144

Phone

(706) 993-2188

Fax

(706) 993-2188

NPI assigned

Oct 16, 2013

Last updated

Oct 16, 2013By 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

Mrs. Elmira Elaine Rouhac, ADMINISTRATOR

Title

RN

Phone

(706) 306-1157

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Agape Living LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Agape Living LLC

  • Case Manager/Care Coordinator
  • Augusta, GA
  • NPI 1942588587
  NPD tax ID

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1427486182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 PHINIZY RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065144",
            "telephone_number": "706-993-2188",
            "fax_number": "706-993-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 PHINIZY RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065144",
            "telephone_number": "706-993-2188",
            "fax_number": "706-993-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "ROUHAC",
        "authorized_official_first_name": "ELMIRA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "706-306-1157",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "GA",
            "license": "121-03-020-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "359961093B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shaghayegh Afzal-Asr, DMD
• Nadeem Afzal, MD
• Edward Villadelgado Agabin, M.D.
• Zachary Scott Agan, PT, DPT
• Agape Day Living LLC
• Agape Living LLC
• Gautam Agarwal, M.B.B.S.
• Ilako Chrystelle Agbatchi-Houedan, NP
• Obiora Agbimson, MD
• Ishan Aggarwal

• Physical Disabilities Residential Treatment Facility in Augusta, GA
• Providers in Augusta, GA by specialty
• Physical Disabilities Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.