Organization
COVENANT INDEPENDENT LIVING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY DAWN JOHNSON (DIRECTOR)
(218) 824-0615
Entity
Organization
Contact information
Practice address
601 NW 5TH ST, BRAINERD, MN 56401-2963
(218) 824-0615
Mailing address
601 NW 5TH ST, BRAINERD, MN 56401-2963
(218) 824-0615
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
10/25/2006
Last updated
07/21/2022
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