Organization
TRINITY MISSION OF ITALY, LLC
Active
Parent organization
COVENANT DOVE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COVENANT DOVE, LLC
Authorized official
DOVE1ITAL J MURPHY (VICE PRESIDENT)
(901) 937-7994
Entity
Organization
Contact information
Practice address
220 DAVENPORT, ITALY, TX 76651-3592
(972) 483-6369
(972) 483-6114
Mailing address
220 DAVENPORT, ITALY, TX 76651-3592
(972) 483-6369
(972) 483-6114
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
116239
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001001871
—
TX
Enumeration date
05/11/2006
Last updated
04/12/2012
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