Provider Demographics
NPI:1467705707
Name:COVENANT LIFE CHRISTIAN CENTER INC
Entity Type:Organization
Organization Name:COVENANT LIFE CHRISTIAN CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-921-1152
Mailing Address - Street 1:PO BOX 2509
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75168-8509
Mailing Address - Country:US
Mailing Address - Phone:972-937-5129
Mailing Address - Fax:972-937-9219
Practice Address - Street 1:507 N HIGHWAY 77 STE 410-412
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1885
Practice Address - Country:US
Practice Address - Phone:972-937-5129
Practice Address - Fax:972-937-9219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable