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General NPI Number Information
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NPI Number | 1508056896
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Entity Type | Organization
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Legal Business Name | THE COVENANT HOME CARE SERVICES, INC
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 2440 TEXAS PKWY STE 150
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City | MISSOURI CITY
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State | TX
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Zip | 77489-4022
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Country | US
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Telephone | 832-884-1411
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Fax | 281-499-4902
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Provider Business Mailing Address
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Address Line | 2440 TEXAS PKWY STE 150
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City | MISSOURI CITY
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State | TX
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Zip | 77489-4022
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Country | US
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Telephone | 832-884-1411
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Fax | 281-499-4902
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. OLUSOLA OLUKEMI AJELETI-OLUFADEJU
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Credential | RN
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Telephone | 832-884-1411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 011158
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License Number State | TX
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