Covenant Comm. Dev. Corp.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

COVENANT COMM. DEV. CORP.

Practice address

1217 Rev S Howard Woodson Jr Way
Trenton, NJ 08638-4015

Phone

(609) 695-0684

Fax

(609) 396-1198

NPI assigned

Sep 7, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Alma Corliss Vincent

Title

Ceo

Phone

(609) 695-0684

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• postive atmosphere reaches kids Former legal business name

Locations

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1194910679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 REV S HOWARD WOODSON JR WAY",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086384015",
            "telephone_number": "609-695-0684",
            "fax_number": "609-396-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 REV S HOWARD WOODSON JR WAY",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086384015",
            "telephone_number": "609-695-0684",
            "fax_number": "609-396-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT COMM. DEV. CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "ALMA",
        "authorized_official_middle_name": "CORLISS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-695-0684",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0022101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "postive atmosphere reaches kids",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Preferred Provider Organization in Trenton, NJ
• Providers in Trenton, NJ by specialty
• Preferred Provider Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.