Organization
COVENANT CARE SERVICES, LLC
Active
Parent organization
COVENANT CARE SERVICES, LLC
Other names
Ashley's Place Adult Day Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
COVENANT CARE SERVICES, LLC
Authorized official
MR. WARREN KEITH REAGAN (OWNER)
(573) 783-6256
Entity
Organization
Contact information
Practice address
407 E 4TH ST, SALEM, MO 65560-1547
(573) 783-6256
(573) 783-8148
Mailing address
PO BOX 110, FREDERICKTOWN, MO 63645-0110
(573) 783-6256
(573) 783-8148
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
1008
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
1008
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245370808
—
MO
05
—
1326188996
—
MO
05
—
1487749537
—
MO
05
—
1770623266
—
MO
05
—
1871823955
—
MO
Enumeration date
09/06/2012
Last updated
09/10/2012
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