# COVENANT LIVING WEST

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mount Miguel Covenant Village Health Facility
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740346212
- **Authorized official:** B.J. FERRIS (MANAGER)
- **Authorized official phone:** (619) 479-4790

## Contact information

- **Practice address:** 325 KEMPTON ST, SPRING VALLEY, CA 91977-5810
- **Practice address phone:** (619) 931-1114
- **Mailing address:** 325 KEMPTON ST, SPRING VALLEY, CA 91977-5810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 090000080 | CA | Yes |

## Other

- **Enumeration date:** 12/29/2006
- **Last updated:** 07/30/2019