NPIMap

Organization Active NPI

Covenant Care Services, LLC

  • Adult Care Home Facility
  • Fredericktown, MO
National Provider Identifier
1871823955
Registry record updated Jan 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
864 Issued in MO
Legal business name
COVENANT CARE SERVICES, LLC
Practice address
1610 W. Hwy 72
Fredericktown, MO 63645
Phone
(573) 783-6256
Fax
(573) 783-8148
NPI assigned
Jan 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2010

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

Authorized official

Name
Warren Keith Reagan
Title
Manager
Phone
(573) 783-6256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 864 MO Primary

Addresses

Primary practice location

1610 W. Hwy 72
Fredericktown, MO 63645

Mailing address

PO Box 110
Fredericktown, MO 63645-0110
Phone (573) 783-6256

Other names 1

  • Ashley's Place Adult Day Care Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Covenant Care Services LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

1610 W Highway 72
Fredericktown, MO 63645
Phone (573) 783-6256

NPI Registry JSON

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1871823955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "636450110",
            "telephone_number": "573-783-6256",
            "fax_number": "573-783-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 W. HWY 72",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "63645",
            "telephone_number": "573-783-6256",
            "fax_number": "573-783-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-12",
        "last_updated": "2010-01-12",
        "status": "A",
        "authorized_official_last_name": "REAGAN",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "573-783-6256"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MO",
            "license": "864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ashley's Place Adult Day Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fredericktown, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.