Provider Demographics
NPI:1356077838
Name:COVERESPITE HOME, LLC
Entity type:Organization
Organization Name:COVERESPITE HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN-NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:501-760-8997
Mailing Address - Street 1:224 MAGNET COVE RD
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-7905
Mailing Address - Country:US
Mailing Address - Phone:501-760-8997
Mailing Address - Fax:
Practice Address - Street 1:224 MAGNET COVE RD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-7905
Practice Address - Country:US
Practice Address - Phone:501-760-8997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR38027OtherDHS, DAAS
AR5816OtherHEALTH FACILITY SVC, DOH