# COVENANT CARE CENTER OF PADUCAH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093855355
- **Authorized official:** RONALD L SANBORN (MANAGING MEMBER)
- **Authorized official phone:** (832) 717-5519

## Contact information

- **Practice address:** 800 7TH STREET, PADUCAH, TX 79248
- **Practice address phone:** (806) 492-3516
- **Practice address fax:** (806) 492-2366
- **Mailing address:** 16203 CHASEMORE DR, SPRING, TX 77379-6603
- **Mailing address phone:** (832) 717-5519
- **Mailing address fax:** (832) 717-5519

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 4459 | TX | Yes |

## Other

- **Enumeration date:** 02/07/2007
- **Last updated:** 10/30/2007