NPIMap

Organization Active NPI

Rudy's Agape House, LLC

  • Adult Day Care Clinic/Center
  • Bradenton, FL
National Provider Identifier
1922421270
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
10666 Issued in FL
Legal business name
RUDY'S AGAPE HOUSE, LLC
Practice address
5426 18TH St W
Bradenton, FL 34207-3305
Phone
(941) 756-0200
Fax
(941) 460-4304
NPI assigned
Jan 22, 2014
Organization subpart
Yes
Parent organization
RUDY'S AGAPE HOUSE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Authorized official

Name
Nancy E Cushman, CORE
Title
Administrator/Owner
Phone
(941) 756-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 10666 FL Primary

Addresses

Primary practice location

5426 18TH St W
Bradenton, FL 34207-3305

Mailing address

5426 18TH St W
Bradenton, FL 34207-3305
Phone (941) 756-0200

Other identifiers 1

IdentifierTypeStateIssuer
004296700MedicaidFL

Other names 1

  • Rudy's Adult Day Care Other name

National Provider Directory

National Provider Directory
Tax ID family
Rudy's Agape House LLC3 organizations share this tax ID, including this one
Part of
Rudy's Agape House LLC

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1922421270",
    "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": "5426 18TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342073305",
            "telephone_number": "941-756-0200",
            "fax_number": "941-460-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUDY'S AGAPE HOUSE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RUDY'S AGAPE HOUSE, LLC",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "CUSHMAN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "941-756-0200",
        "authorized_official_credential": "CORE"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "FL",
            "license": "10666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004296700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rudy's Adult Day Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.