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General NPI Number Information
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NPI Number | 1861582595
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Entity Type | Organization
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Legal Business Name | COVENANT HOME CARE
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 10/04/2011
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Provider Practice Location Address
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Address Line | 1223 POTTSVILLE PIKE
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City | SHOEMAKERSVILLE
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State | PA
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Zip | 19555-1719
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Country | US
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Telephone | 800-726-8761
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Fax | 570-385-5287
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Provider Business Mailing Address
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Address Line | 1223 POTTSVILLE PIKE
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City | SHOEMAKERSVILLE
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State | PA
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Zip | 19555-1719
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Country | US
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Telephone | 800-726-8761
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Fax | 570-385-5287
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. SANDRA LEE LEVENGOOD
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Credential | MBA, RN
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Telephone | 800-726-8761
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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 | 712905
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 159199
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License Number State | PA
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