NPIMap

Organization Active NPI

Covenant Home Services

Doing business as CovenantCare at Home

  • Nursing Care Agency
  • St Charles, IL
National Provider Identifier
1730301979
Registry record updated Oct 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
4000133 Issued in IL
Legal business name
COVENANT HOME SERVICES
Doing business as
CovenantCare at Home
Practice address
3755 E Main St
Suite 165
St Charles, IL 60174-2463
Phone
(630) 845-0680
Fax
(630) 444-1688
NPI assigned
May 3, 2007
Last updated
Oct 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2013

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

Authorized official

Name
Mr. Joseph D Haughney
Title
President
Phone
(630) 845-0680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 4000133 IL Primary

Addresses

Primary practice location

3755 E Main St
Suite 165
St Charles, IL 60174-2463

Mailing address

3755 E Main St
Suite 165
St Charles, IL 60174-2463
Phone (630) 845-0680

Other identifiers 1

IdentifierTypeStateIssuer
4521270OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • CovenantCare at Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Covenant Home Services7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3755 E Main St
Ste 165
St Charles, IL 60174
Phone (630) 845-0680

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382054400000",
    "number": "1730301979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 E MAIN ST",
            "address_2": "SUITE 165",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742463",
            "telephone_number": "630-845-0680",
            "fax_number": "630-444-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 E MAIN ST",
            "address_2": "SUITE 165",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742463",
            "telephone_number": "630-845-0680",
            "fax_number": "630-444-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HOME SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2013-10-18",
        "status": "A",
        "authorized_official_last_name": "HAUGHNEY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-845-0680",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "IL",
            "license": "4000133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4521270",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CovenantCare at Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; 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.