Provider Demographics
NPI:1497292809
Name:AGAPE VILLAGES, INC.
Entity Type:Organization
Organization Name:AGAPE VILLAGES, INC.
Other - Org Name:AGAPE VILLAGES FOSTER FAMILY AGENCY
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BANGON
Authorized Official - Middle Name:
Authorized Official - Last Name:BADIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-866-3020
Mailing Address - Street 1:3160 CROW CANYON PL
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1100
Mailing Address - Country:US
Mailing Address - Phone:925-866-3020
Mailing Address - Fax:925-866-0305
Practice Address - Street 1:3160 CROW CANYON PL
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1100
Practice Address - Country:US
Practice Address - Phone:925-866-3020
Practice Address - Fax:925-866-0305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA397005335253J00000X
CA015202681253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency