# COVENANT CARE SENIOR LIVING, INC

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

## Provider details

- **NPI number:** 1295070225
- **Authorized official:** GLENNIS SVANDA RN (OWNER/OPERATOR)
- **Authorized official phone:** (316) 665-9996

## Contact information

- **Practice address:** 14422 E TWINLAKE DR, WICHITA, KS 67230-9517
- **Practice address phone:** (316) 665-9996
- **Practice address fax:** (316) 733-1771
- **Mailing address:** 14422 E TWINLAKE DR, WICHITA, KS 67230-9517
- **Mailing address phone:** (316) 665-9996
- **Mailing address fax:** (316) 733-1771

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | BO87158 | KS | Yes |

## Other

- **Enumeration date:** 12/03/2012
- **Last updated:** 12/03/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200653180A | — | KS |