MEDICARE: THE COVENANT HOME CARE SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	011158	TX

General Provider Information

NPI Number	:	1508056896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE COVENANT HOME CARE SERVICES, INC

Provider Business Mailing Address
First Line	:	2440 TEXAS PKWY STE 150
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-4022
Country	:	US
Telephone Number	:	832-884-1411
Fax Number	:	281-499-4902

Provider Business Practice Location Address
First Line	:	2440 TEXAS PKWY STE 150
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-4022
Country	:	US
Telephone Number	:	832-884-1411
Fax Number	:	281-499-4902

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. OLUSOLA OLUKEMI AJELETI-OLUFADEJU
Credential	:	RN
Telephone Number	:	832-884-1411

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	08/17/2010

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