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Organization

RUDY'S AGAPE HOUSE, LLC

Active
Other names
Rudy's Agape House II
Organization subpart
No

Provider details

NPI number
Authorized official
NANCY E CUSHMAN (OWNER)
(941) 756-0200
Entity
Organization

Contact information

Practice address
2104 55TH AVE W, BRADENTON, FL 34207-3240
(941) 755-0225
(941) 460-4304
Mailing address
5426 18TH ST W, BRADENTON, FL 34207-3305
(941) 756-0200
(941) 460-4304

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
12857
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004296700
FL
Enumeration date
08/18/2016
Last updated
08/18/2016
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