Covenant Place of Waxahachie

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

117586 Issued in TX

Legal business name

COVENANT PLACE OF WAXAHACHIE

Practice address

401 Solon Rd
Waxahachie, TX 75165-1328

Phone

(972) 935-9363

Fax

(972) 923-3289

NPI assigned

Sep 29, 2006

Organization subpart

No

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

Authorized official

Name

Keith Johannessen

Title

President & Coo

Phone

(972) 770-5600

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Covenant Place of Abilene3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Covenant Place of Abilene

  • Assisted Living Facility
  • Abilene, TX
  • NPI 1356433189
  NPD tax ID
• Good Place

  • Assisted Living Facility
  • North Richland Hills, TX
  • NPI 1326130188
  NPD tax ID

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1831281609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14160 DALLAS PKWY",
            "address_2": "SUITE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752544319",
            "telephone_number": "972-770-5600",
            "fax_number": "972-770-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SOLON RD",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651328",
            "telephone_number": "972-935-9363",
            "fax_number": "972-923-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT PLACE OF WAXAHACHIE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "JOHANNESSEN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT & COO",
        "authorized_official_telephone_number": "972-770-5600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "117586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBA CONTRACT #",
            "identifier": "001014421",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001015630",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corshe Transport, LLC
• Linda J Cosgrove, DC
• Colby Christopher Cottongame, DDS
• Counseling Center of Ellis County
• Covenant Life Christian Center Inc
• Geoffrey A Cox, PT
• Alyssa Craig, OTR
• Takhaira Arshun Craig, MAT,LAT,ATC
• Jonathan Duane Creek, FNP-C
• Audrey M Crouch, LPC, LCDC

• Assisted Living Facility in Waxahachie, TX
• Providers in Waxahachie, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.