Organization
COVENANT CHILD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAT M RUPE MSW (EXECUTIVE DIRECTOR)
(575) 746-6277
Entity
Organization
Contact information
Practice address
801 W BUSH AVE, ARTESIA, NM 88210-1255
(575) 746-6277
(575) 746-6471
Mailing address
801 W BUSH AVE, ARTESIA, NM 88210-1255
(575) 746-6277
(575) 746-6471
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020080358
CITY OF ARTESIA BUSINESS LICENSE
NM
Enumeration date
02/09/2009
Last updated
02/09/2009
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