Healthcare Provider Details

I. General information

NPI: 1437741451
Provider Name (Legal Business Name): AGAPES WAY 1A INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1823 PEARWOOD CT
ORLANDO FL
32818-5837
US

IV. Provider business mailing address

5401 S KIRKMAN RD STE 214A
ORLANDO FL
32819-7940
US

V. Phone/Fax

Practice location:
  • Phone: 727-483-3066
  • Fax:
Mailing address:
  • Phone: 727-483-3066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CHIRIGA OFORI
Title or Position: OWNER
Credential:
Phone: 727-483-3066