Provider Demographics
NPI:1477909604
Name:AGAPE TRANSIT LLC
Entity Type:Organization
Organization Name:AGAPE TRANSIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNY
Authorized Official - Middle Name:H
Authorized Official - Last Name:TESFAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-667-9836
Mailing Address - Street 1:1660 S CHAMBERS RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017
Mailing Address - Country:US
Mailing Address - Phone:303-667-9836
Mailing Address - Fax:
Practice Address - Street 1:1660 S CHAMBERS RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017
Practice Address - Country:US
Practice Address - Phone:303-667-9836
Practice Address - Fax:303-755-1904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-06
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20161272243343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20161272722243Medicaid