Healthcare Provider Details

I. General information

NPI: 1699009670
Provider Name (Legal Business Name): COVENANT HOME SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 01/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 HARLAN ST SUITE 135
WESTMINSTER CO
80031-2924
US

IV. Provider business mailing address

5700 OLD ORCHARD RD
SKOKIE IL
60077-1036
US

V. Phone/Fax

Practice location:
  • Phone: 303-487-1009
  • Fax: 303-487-1104
Mailing address:
  • Phone: 773-878-4315
  • Fax: 773-878-5222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH D HAUGHNEY
Title or Position: PRESIDENT
Credential:
Phone: 773-878-4315