Organization
COVENANT IN-HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW MARTIN (OWNER/PRESIDENT)
(704) 650-5034
Entity
Organization
Contact information
Practice address
3901 GLENFALL AVE, CHARLOTTE, NC 28210-6307
(704) 288-0242
(704) 643-8197
Mailing address
3901 GLENFALL AVE., CHARLOTTE, NC 28210
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HC4259
NC
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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