Healthcare Provider Details

I. General information

NPI: 1982908182
Provider Name (Legal Business Name): COVENANT FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 N ALMA SCHOOL RD SUITE 3
CHANDLER AZ
85224-4379
US

IV. Provider business mailing address

325 N ALMA SCHOOL RD SUITE 3
CHANDLER AZ
85224-4379
US

V. Phone/Fax

Practice location:
  • Phone: 480-812-1616
  • Fax: 480-659-9351
Mailing address:
  • Phone: 480-812-1616
  • Fax: 480-659-9351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberBH3750
License Number StateAZ

VIII. Authorized Official

Name: MRS. SHERIOLYN M LASLEY
Title or Position: CEO
Credential: MDIV
Phone: 480-812-1616