Organization
AGAPE INDEPENDENT LIVING GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALLAN J SOTO (CEO)
(706) 399-3007
Entity
Organization
Contact information
Practice address
830 GRACERN RD, COLUMBIA, SC 29210-7629
(706) 842-5330
Mailing address
209 7TH ST FL 5, AUGUSTA, GA 30901-1484
(706) 842-5330
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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