Provider Demographics
NPI:1790372837
Name:COVENANT HEALTH SERVICES INC
Entity Type:Organization
Organization Name:COVENANT HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:FREDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBOGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-980-3975
Mailing Address - Street 1:11 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:MA
Mailing Address - Zip Code:02322-1918
Mailing Address - Country:US
Mailing Address - Phone:617-980-3975
Mailing Address - Fax:
Practice Address - Street 1:11 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:MA
Practice Address - Zip Code:02322-1918
Practice Address - Country:US
Practice Address - Phone:617-980-3975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle