Organization
COVENANT PREMIUM SENIOR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRICK JACKSON PHD (PRESIDENT & CHAIRMAN)
(281) 394-9217
Entity
Organization
Contact information
Practice address
28307 SUGARSIDE GLEN DR, KATY, TX 77494-1480
(281) 394-9217
(281) 394-9216
Mailing address
2918 CHAPEL ROCK, KATY, TX 77494-5256
(281) 394-9217
(281) 394-9216
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/10/2016
Last updated
01/10/2017
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