Organization
COVENANT HOME SERVICES
Active
Other names
CovenantCare at Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH D HAUGHNEY (PRESIDENT)
(630) 845-0680
Entity
Organization
Contact information
Practice address
3755 E MAIN ST, SUITE 165, ST CHARLES, IL 60174-2463
(630) 845-0680
(630) 444-1688
Mailing address
3755 E MAIN ST, SUITE 165, ST CHARLES, IL 60174-2463
(630) 845-0680
(630) 444-1688
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
4000133
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4521270
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/03/2007
Last updated
10/18/2013
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