Organization
COVENANT HOUSE MRDD SERVICES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOB HENRY DUCKENS SR. (C.E.O)
(614) 561-0390
Entity
Organization
Contact information
Practice address
479 SEYMOUR AVE, COLUMBUS, OH 43205-2566
(614) 309-0395
(614) 252-6787
Mailing address
479 SEYMOUR AVE, COLUMBUS, OH 43205-2566
(614) 309-0395
(614) 252-6787
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253Z00000X
—
OH
Enumeration date
06/30/2026
Last updated
06/30/2026
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