Provider Demographics
NPI:1215383856
Name:COVENANT HOME HEALTH SERVICES L.L.C.
Entity Type:Organization
Organization Name:COVENANT HOME HEALTH SERVICES L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:
Authorized Official - Last Name:IRUBOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-235-3417
Mailing Address - Street 1:2235 E FLAMINGO RD STE 124
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5151
Mailing Address - Country:US
Mailing Address - Phone:702-734-0554
Mailing Address - Fax:702-734-0092
Practice Address - Street 1:2235 E FLAMINGO RD STE 124
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5151
Practice Address - Country:US
Practice Address - Phone:702-734-0554
Practice Address - Fax:702-894-5529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2021-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7847HHA-0251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health