Organization
COVENANT CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLONDELL P SIMPSON (OWNER/ DIRECTOR)
(336) 542-6396
Entity
Organization
Contact information
Practice address
1208 SLOAN ST, GREENSBORO, NC 27401-3442
(336) 339-9788
Mailing address
1208 SLOAN ST, GREENSBORO, NC 27401-3442
(336) 542-6396
(336) 694-1675
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
MHL 041 1088
NC
Other
Enumeration date
12/02/2013
Last updated
08/28/2015
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