Organization
RUDY'S AGAPE HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY E CUSHMAN (OWNER/ADMINISTRATOR)
(941) 756-0200
Entity
Organization
Contact information
Practice address
5426 18TH ST W, BRADENTON, FL 34207-3305
(941) 756-0200
Mailing address
5426 18TH ST W, BRADENTON, FL 34207-3305
(941) 756-0200
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
10666
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004296700
—
FL
Enumeration date
12/03/2011
Last updated
01/16/2014
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