Provider Demographics
NPI:1891585279
Name:GRADISON AGAPE HOMES INC.
Entity type:Organization
Organization Name:GRADISON AGAPE HOMES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MADISON
Authorized Official - Middle Name:GBAFUWEL
Authorized Official - Last Name:BEOHTWEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-580-8855
Mailing Address - Street 1:225 MATLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3273
Mailing Address - Country:US
Mailing Address - Phone:402-318-2805
Mailing Address - Fax:
Practice Address - Street 1:8315 BALLINA RIDGE CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-6399
Practice Address - Country:US
Practice Address - Phone:402-580-8855
Practice Address - Fax:402-318-2805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities