Organization
COVENANT OF COMPANIONSHIP, LLC
Active
Other names
Covenant of Companionship, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MAKEBA JANEA WASHINGTON LVN (CHIEF EXECUTIVE OFFICER)
(469) 682-9506
Entity
Organization
Contact information
Practice address
1919 MCKINNEY AVE STE 1015, DALLAS, TX 75201-2495
(469) 682-9506
Mailing address
1919 MCKINNEY AVE STE 1015, DALLAS, TX 75201-2495
(469) 682-9506
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9999999
NONE
—
Enumeration date
11/18/2020
Last updated
11/18/2020
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