Provider Demographics
NPI:1689071649
Name:COVENANT HOME HEALTHCARE, INC,
Entity Type:Organization
Organization Name:COVENANT HOME HEALTHCARE, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-778-8114
Mailing Address - Street 1:29860 W 12 MILE RD APT 602
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4040
Mailing Address - Country:US
Mailing Address - Phone:248-778-8114
Mailing Address - Fax:248-432-7339
Practice Address - Street 1:29860 W 12 MILE RD APT 602
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4040
Practice Address - Country:US
Practice Address - Phone:248-778-8114
Practice Address - Fax:248-432-7339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health