Provider Demographics
NPI:1669418539
Name:COVENANT HOME HEALTH SERVICES, INC
Entity type:Organization
Organization Name:COVENANT HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELSIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-630-7770
Mailing Address - Street 1:8500 N STEMMONS FWY
Mailing Address - Street 2:STE 1005
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-3832
Mailing Address - Country:US
Mailing Address - Phone:214-630-7770
Mailing Address - Fax:214-630-7272
Practice Address - Street 1:8500 N STEMMONS FWY
Practice Address - Street 2:STE 1005
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-3832
Practice Address - Country:US
Practice Address - Phone:214-630-7770
Practice Address - Fax:214-630-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007984251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679155Medicare ID - Type Unspecified