Provider Demographics
NPI:1326469107
Name:COVENANT HOME CARE MINISTRIES
Entity Type:Organization
Organization Name:COVENANT HOME CARE MINISTRIES
Other - Org Name:COVENANT ACADEMY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:RN MS
Authorized Official - Phone:248-593-6170
Mailing Address - Street 1:1133 W LONG LAKE RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1983
Mailing Address - Country:US
Mailing Address - Phone:248-593-6170
Mailing Address - Fax:248-593-6002
Practice Address - Street 1:1133 W LONG LAKE RD
Practice Address - Street 2:SUITE 150
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-1983
Practice Address - Country:US
Practice Address - Phone:248-593-6170
Practice Address - Fax:248-593-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-23
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI749550253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care