Provider Demographics
NPI:1083206338
Name:AGAPES WAY 2A INC
Entity Type:Organization
Organization Name:AGAPES WAY 2A INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHIRIGA
Authorized Official - Middle Name:
Authorized Official - Last Name:OFORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-483-3066
Mailing Address - Street 1:5401 S KIRKMAN RD STE 214A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7940
Mailing Address - Country:US
Mailing Address - Phone:727-483-3066
Mailing Address - Fax:407-205-0052
Practice Address - Street 1:245 S VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-5667
Practice Address - Country:US
Practice Address - Phone:727-483-3066
Practice Address - Fax:407-205-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health