# COVENANT WOODS

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

## Provider details

- **NPI number:** 1215093737
- **Authorized official:** MR. ERIK MAURITSEN (COMPLIANCE OFFICER)
- **Authorized official phone:** (804) 569-8173

## Contact information

- **Practice address:** 7090 COVENANT WOODS DR, MECHANICSVILLE, VA 23111-7025
- **Practice address phone:** (804) 569-8000
- **Practice address fax:** (804) 569-8177
- **Mailing address:** 7090 COVENANT WOODS DR, MECHANICSVILLE, VA 23111-7025
- **Mailing address phone:** (804) 569-8000
- **Mailing address fax:** (804) 569-8177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 12/29/2006
- **Last updated:** 10/12/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | NH2662 | NURSING HOME LICENSE NUMBER | VA |