Healthcare Provider Details

I. General information

NPI: 1083916381
Provider Name (Legal Business Name): COVENANT COMMUNITY PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2010
Last Update Date: 11/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 CHAPEL HILL RD
DURHAM NC
27707-1175
US

IV. Provider business mailing address

1803 CHAPEL HILL RD
DURHAM NC
27707-1175
US

V. Phone/Fax

Practice location:
  • Phone: 919-401-8000
  • Fax: 919-401-8006
Mailing address:
  • Phone: 919-401-8000
  • Fax: 919-401-8006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number StateNC

VIII. Authorized Official

Name: MRS. YVETTE JOY MUNROE
Title or Position: CEO/DIRECTOR
Credential:
Phone: 919-401-8000