Organization
COVENANT OF LOVE UUL CORPORATION
Active
Other names
Covenant of Love Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLENE WHITE BYNUM DR. STUDENT HCA (PRESIDENT, ADMINISTRATOR, CADC)
(702) 810-4830
Entity
Organization
Contact information
Practice address
408 ELDORADO HILLS CT, LAS VEGAS, NV 89110-5646
(702) 810-4830
(702) 255-7766
Mailing address
408 ELDORADO HILLS CT, LAS VEGAS, NV 89110-5646
(702) 810-4830
(702) 255-7766
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5464TLF-1
NV
302F00000X
Exclusive Provider Organization
5061AGC-1
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251S00000X
—
NV
Enumeration date
12/28/2010
Last updated
12/28/2010
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