Organization
COVENANT COVE CARE LLC
Active
Other names
Covenant cove care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGEANNA STOKES (OWNER)
(662) 647-7546
Entity
Organization
Contact information
Practice address
101 KIRK AVE APT C7, GRENADA, MS 38901-2880
(662) 647-7546
Mailing address
101 KIRK AVE APT C7, GRENADA, MS 38901-2880
(662) 647-7546
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
310400000X
Assisted Living Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033983184
—
MS
Enumeration date
11/09/2023
Last updated
03/07/2024
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