Provider Demographics
NPI:1396210076
Name:AGAPE ANGELS
Entity Type:Organization
Organization Name:AGAPE ANGELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-649-3576
Mailing Address - Street 1:1418 BRICE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-2397
Mailing Address - Country:US
Mailing Address - Phone:614-367-6605
Mailing Address - Fax:614-367-6499
Practice Address - Street 1:1418 BRICE RD STE 100
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2397
Practice Address - Country:US
Practice Address - Phone:614-367-6605
Practice Address - Fax:614-367-6499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No174200000XOther Service ProvidersMeals
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)