Provider Demographics
NPI:1013569474
Name:COVENANT HOME HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:COVENANT HOME HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:CADET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-612-2286
Mailing Address - Street 1:17620 HENLEY RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2230
Mailing Address - Country:US
Mailing Address - Phone:718-739-8606
Mailing Address - Fax:718-360-9669
Practice Address - Street 1:17620 HENLEY RD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-2230
Practice Address - Country:US
Practice Address - Phone:718-739-8606
Practice Address - Fax:718-360-9669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health