Organization
LIBERTY HEALTH & REHAB OF INDIANOLA, LLC
Active
Parent organization
COVENANT DOVE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COVENANT DOVE, LLC
Authorized official
CHRISTOPHER J MURPHY (VICE PRESIDENT)
(901) 937-7994
Entity
Organization
Contact information
Practice address
401 HIGHWAY 82 W, INDIANOLA, MS 38751-2030
(662) 887-2682
(662) 887-3817
Mailing address
401 HIGHWAY 82 W, INDIANOLA, MS 38751-2030
(662) 887-2682
(662) 887-3817
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06836221
—
MS
Enumeration date
12/08/2009
Last updated
04/12/2012
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