# COVENANT ELDER HEALTH SERVICES & MANAGEMENT LLC

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

## Provider details

- **NPI number:** 1679064323
- **Authorized official:** DR. HIEP PHAM (PRESIDENT)
- **Authorized official phone:** (704) 995-6643

## Contact information

- **Practice address:** 2116 SAM WILSON RD, CHARLOTTE, NC 28214-9083
- **Practice address phone:** (704) 995-6643
- **Mailing address:** PO BOX 78967, CHARLOTTE, NC 28271-7045

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 05/29/2018
- **Last updated:** 05/29/2018