Agape Nursing & Rehabilitation Center, LLC

Organization Active NPI Skilled Nursing Facility · Johnson City, TN

NPI 1780099861 · NPPES record last updated Jan 28, 2015

Key facts

NPI
1780099861
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
Legal business name
AGAPE NURSING & REHABILITATION CENTER, LLC
Practice address
105 W Myrtle Ave
Johnson City, TN 37604-5633
Phone
(423) 975-5455
Fax
(423) 975-5405
NPI assigned
Jun 26, 2014
Organization subpart
No

Authorized official

Name
Mrs. Lisa M. Cawood-Gray
Title
Risk Consultant
Phone
(423) 773-4485

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X TN
Skilled Nursing Facility 314000000X TN Yes

Addresses

Primary practice location

105 W Myrtle Ave
Johnson City, TN 37604-5633

Mailing address

2020 Northpark Dr
Suite 2D
Johnson City, TN 37604-3100
Phone (423) 975-5455

Other identifiers

IdentifierTypeStateIssuer
0445019MedicaidTN
7440618MedicaidTN

Other providers in Johnson City, TN

All providers in Johnson City, TN · Skilled Nursing Facility in Tennessee

Sources for this page

Verify at the official NPI Registry.