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General NPI Number Information
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NPI Number | 1245370808
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Entity Type | Organization
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Legal Business Name | COVENANT CARE SERVICES, LLC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 120 S MINE LA MOTTE ST
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City | FREDERICKTOWN
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State | MO
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Zip | 63645-1229
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Country | US
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Telephone | 573-783-6256
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Fax | 573-783-8148
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Provider Business Mailing Address
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Address Line | 120 S MINE LA MOTTE ST
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City | FREDERICKTOWN
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State | MO
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Zip | 63645-1229
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Country | US
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Telephone | 573-783-6256
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Fax | 573-783-8148
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Authorized Official
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Title or Position | MEMBER-MANAGER
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Name | MR. WARREN K REAGAN
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Credential |
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Telephone | 573-783-6256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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