Provider Demographics
NPI:1891083366
Name:COVENANTHOME SERVICES
Entity Type:Organization
Organization Name:COVENANTHOME SERVICES
Other - Org Name:COVENANTCARE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:HAUGHNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-878-4315
Mailing Address - Street 1:5700 OLD ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1036
Mailing Address - Country:US
Mailing Address - Phone:773-878-4315
Mailing Address - Fax:
Practice Address - Street 1:5800 SAINT CROIX AVE N
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4446
Practice Address - Country:US
Practice Address - Phone:763-732-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based