RUDY'S AGAPE HOUSE, LLC (NPI# 1114472263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114472263 |
| Entity Type | Organization |
| Organization Name | RUDY'S AGAPE HOUSE, LLC |
| Other Organization Name | RUDY'S AGAPE HOUSE II |
| Practice Address |
2104 55th Ave W Bradenton FL 34207-3240 |
| Mailing Address |
5426 18th St W Bradenton FL 34207-3305 |
| Practice Telephone | 9417550225 |
| Practice Fax Number | 9414604304 |
| Mailing Telephone | 9417560200 |
| Mailing Fax Number | 9414604304 |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |
| Authorized Official Name | NANCY E CUSHMAN (OWNER) |
| Authorized Official Telephone | 9417560200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 12857 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 004296700 | 05 |
| Other Name | Type Code |
|---|---|
| Rudy's Agape House II | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841568961 | Rudy's Agape House, LLC | Assisted Living Facility | 5426 18th St W, Bradenton, FL 34207-3305 | 2011-12-03 |
| 1922421270 | Rudy's Agape House, LLC | Clinic/Center | 5426 18th St W, Bradenton, FL 34207-3305 | 2014-01-22 |
| Street Address |
2104 55TH AVE W |
| City | BRADENTON |
| State | FL |
| Zip Code | 34207-3240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659674893 | Dawn Rae Mack | Custodial Care Facility | 2104 55th Ave W, Bradenton, FL 34207-3240 | 2010-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932760543 | Yaima Alba | Dentist | 1602 State Hwy 684 W, Bradenton, FL 34207 | 2019-06-25 |
| 1770069361 | America's Pharmacy LLC. | Pharmacy | 5612 14th St W, Bradenton, FL 34207 | 2018-07-17 |
| 1265817829 | Elizabeth Anne Gross Baumgartner | Nurse Practitioner | 5515 27th St West, Bradenton, FL 34207 | 2015-07-24 |
| 1710152673 | Oasis Temps Health Care, Inc. | Nursing Care | 4814 26th Street West, Unit B, Bradenton, FL 34207 | 2008-04-22 |
| 1669694873 | Comfortable Care Dental Health Professionals, Pa | Dentist | 6513 14th Street West, Suite 131, Bradenton, FL 34207 | 2007-05-03 |
| 1831258524 | Susan Marie Mackey | Counselor | New View Counseling, 4506 26th Street West Suite C, Bradenton, FL 34207 | 2006-12-08 |
| 1073672333 | Debra K Carter | Psychologist | 4835 27th St West, Suite 125, Bradenton, FL 34207 | 2006-12-06 |
| 1033285952 | Neuromuscular Insitutute Inc | Physical Therapist | 4802 26th St West, Suite C, Bradenton, FL 34207 | 2006-11-24 |
| 1346315561 | Judith Rhea Korn | Social Worker | 6108 26th St West, Suite 3b, Bradenton, FL 34207 | 2006-11-22 |
| 1770652018 | Richard Allen Feasley | Dentist | 4418 5th St W, Bradenton, FL 34207 | 2006-11-08 |
| Find all providers in zip 34207 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992250633 | Resident Care Prime Consultants, LLC | Assisted Living Facility | 1801 51st St W, Bradenton, FL 34209-5031 | 2016-08-23 |
| 1518334648 | Twin Angels Assisted Living Facility | Assisted Living Facility | 323 49th St Nw, Bradenton, FL 34209-1922 | 2015-08-24 |
| 1447650528 | Lisa Bryan | Assisted Living Facility | 5015 29th Ave W, Bradenton, FL 34209-6119 | 2014-08-26 |
| 1467862276 | Dorcas House | Assisted Living Facility | 2601 13th Ave W, Bradenton, FL 34205-4030 | 2014-05-01 |
| 1255766697 | Oaks Bradenton Trs, LLC | Assisted Living Facility | 2614 43rd St W, Bradenton, FL 34209-6212 | 2013-09-04 |
| 1053751693 | 60th Avenue Alf, LLC | Assisted Living Facility | 2800 60th Ave W, Bradenton, FL 34207-4324 | 2013-06-27 |
| 1780028415 | Nic 4 Summerfield Leasing LLC | Assisted Living Facility | 3409 26th St. W., Bradenton, FL 34205 | 2013-04-24 |
| 1164866869 | Nic 4 Bradenton Oaks Leasing LLC | Assisted Living Facility | 1015 7th Ave East, Bradenton, FL 34208 | 2013-04-24 |
| 1295072262 | Neuro International LLC | Assisted Living Facility | 7015 32nd Ave E, Bradenton, FL 34208-6755 | 2013-01-11 |
| 1144582461 | Waters Edge of Bradeton | Assisted Living Facility | 2015 32nd Ave W, Bradenton, FL 34205-4505 | 2012-06-12 |
| Find all providers in BRADENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.