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AGAPE FAMILY MEDICAL CENTER LLC
NPI 1316559248
Nurse Practitioner - Family in Waterbury, CT

Active since August 21, 2020CLIA 07D2192820 · Waiver
1078 W MAIN ST STE 3, WATERBURY, CT 06708(860) 797-0572 Get Directions Write a Review

NPPES record last updated: August 21, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Agape Family Medical Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AGAPE FAMILY MEDICAL CENTER LLC (NPI 1316559248) is a healthcare organization registered as a family in Waterbury, Connecticut and active in the NPI registry since August 2020. The organization holds a CLIA Waiver certificate valid through September 14, 2026 and lists Felistas Mazhandu, Owner, as its authorized official.

NPPES Registry Identity

NPI1316559248
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameAGAPE FAMILY MEDICAL CENTER LLC
Location Address1078 W MAIN ST STE 3Waterbury, CT 06708-2651
Mailing Address4 Woodland TrlEllington, CT 06029-3890 · (860) 797-0572
Phone(860) 797-0572
Organization SubpartNo
Authorized OfficialFelistas MazhanduOwner · (860) 797-0572
Enumeration DateAugust 21, 2020
NPPES CertifiedAugust 21, 2020
✔ NPI 1316559248 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
1078 W MAIN ST STE 3, Waterbury, CT 06708
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D2192820

Agape Family Medical Center LLC · Waterbury, CT
Active · expires Sep 14, 2026
CLIA Number07D2192820
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 15, 2024
Certificate Expiration DateSeptember 14, 2026
Laboratory DirectorFelistas Mazhandu Aprn
Laboratory Phone(860) 797-0572
Laboratory LocationAgape Family Medical Center LLC1078 West Main St, Suite 3, Waterbury, CT 06708
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AGAPE FAMILY MEDICAL CLINIC INC
Nurse Practitioner (Family)
1078 W MAIN ST STE 3
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 527-3576

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Agape Family Medical Center LLC's NPI number?

The NPI number for Agape Family Medical Center LLC is 1316559248. It was assigned to this organization in the NPPES registry on August 21, 2020.

Where is Agape Family Medical Center LLC located?

Agape Family Medical Center LLC is located at 1078 W Main St Ste 3, Waterbury, CT 06708. The listed phone number is (860) 797-0572.

What is Agape Family Medical Center LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Agape Family Medical Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D2192820) is associated with this NPI, valid through September 14, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Agape Family Medical Center LLC was last updated on August 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.