Organization
AGAPE SUPPORTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC RICHARD VAHLE (OWNER)
(573) 881-9624
Entity
Organization
Contact information
Practice address
3611 WAKEFIELD DR, COLUMBIA, MO 65203-4462
(573) 881-6557
Mailing address
3015 HILL HAVEN LN, COLUMBIA, MO 65202-2653
(573) 881-9624
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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