Covenant Care Center of Vernon, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

4808 Issued in TX

Legal business name

COVENANT CARE CENTER OF VERNON, LLC

Practice address

4301 Hospital Dr
Vernon, TX 76384-3135

Phone

(940) 552-2568

Fax

(940) 552-2019

NPI assigned

Feb 6, 2007

Last updated

Oct 30, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ronald L Sanborn

Title

Managing Member

Phone

(832) 717-5519

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1043350614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16203 CHASEMORE DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773796603",
            "telephone_number": "832-717-5519",
            "fax_number": "832-717-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 HOSPITAL DR",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763843135",
            "telephone_number": "940-552-2568",
            "fax_number": "940-552-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT CARE CENTER OF VERNON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "SANBORN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "832-717-5519"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "4808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Vernon (City of Vernon Fire/EMS Dept)
• Kayla Marie Clayton
• Rikki Nicole Collier, MA, LPC
• Carrie Allison Couch, MS, CCC/SLP
• David B. Couch, MAMFC, LPC
• Holland Joy Davis, PHARMD
• Sue Ellen Davis, L.P.C.
• Misti Dickerson, LPC
• Jeffrey Dobbins, APRN, PMHNP-BC
• Dr Randall Schaffner & Lindsay Streit Gen PTR

• Skilled Nursing Facility in Vernon, TX
• Providers in Vernon, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.