COVENANT CARE SERVICES LLC (NPI# 1720419641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720419641 |
| Entity Type | Organization |
| Organization Name | COVENANT CARE SERVICES LLC |
| Practice Address |
1208 Sloan St Greensboro NC 27401-3442 |
| Practice Telephone | 3363399788 |
| Mailing Telephone | 3365426396 |
| Mailing Fax Number | 3366941675 |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2015-08-28 |
| Authorized Official Name | BLONDELL P SIMPSON (OWNER/ DIRECTOR) |
| Authorized Official Telephone | 3365426396 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
MHL 041 1088 | NC | Nursing & Custodial Care Facilities |
| Street Address |
1208 SLOAN ST |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27401-3442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912103664 | G & D Residential Services, LLC | Community Based Residential Treatment Facility, Mental Illness | 1208 Sloan St, Greensboro, NC 27401-3442 | 2007-06-21 |
| 1821294570 | G & D Residential Services | Community Based Residential Treatment Facility, Mental Illness | 1208 Sloan St, Greensboro, NC 27401-3442 | 2007-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779655 | Warfair Counseling, Consulting, & Supervision, Pllc | Counselor | 301 South Elm Street, Suite 801, Greensboro, NC 27401 | 2020-10-28 |
| 1225636848 | Alma Lucero Diaz | Registered Nurse | 1121 North Church St, Greensboro, NC 27401 | 2020-10-15 |
| 1447865217 | Rebecca Levy | Marriage & Family Therapist | Cone Health Family Medicine 1125 N Church Street, Greensboro, NC 27401 | 2020-09-09 |
| 1346854304 | Rayna's Home Care, LLC | Registered Nurse | 823 North Elm Street, Greensboro, NC 27401 | 2020-09-06 |
| 1316574718 | Garrett Green | Physician Assistant | 1121 N Church St., Greensboro, NC 27401 | 2020-03-25 |
| 1629635685 | Lauren Robinson Byrd | Anesthesiology | 1200 North Church St, Greensboro, NC 27401 | 2019-05-24 |
| 1285103069 | Shannon Marie Childs Meyerhoff | Occupational Therapist | Guilford County Schools Ec, 134 Franklin Blvd, Greensboro, NC 27401 | 2018-11-21 |
| 1194293241 | Ashley Marie Smith | Nurse Practitioner | 1200 North Elm St, Greensboro, NC 27401 | 2018-11-07 |
| 1285117762 | Anastazia Juszczak Gray | Speech-Language Pathologist | 1131 N. Church St, Greensboro, NC 27401 | 2018-09-11 |
| 1619474012 | Jamie Hannah Rose Aldridge | Psychiatry & Neurology | 1121 N Church Street, Greensboro, NC 27401 | 2018-04-11 |
| Find all providers in zip 27401 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265998124 | Valerie Smith | Assisted Living Facility | 112 Shore Lake Dr Apt A, Greensboro, NC 27455-1452 | 2019-02-15 |
| 1669801379 | A Second Chance for Life | Assisted Living Facility | 3810 Pineneedle Dr, Greensboro, NC 27405-2911 | 2013-11-03 |
| 1801037247 | Milton's Manor | Assisted Living Facility | 1607 Martin Luther King Jr Dr, Greensboro, NC 27406-2423 | 2009-03-16 |
| 1538288030 | Thornton Court Group Home | Assisted Living Facility | 115 Thornton Ct, Greensboro, NC 27407-1429 | 2007-03-28 |
| 1386763894 | Carter Group Home | Assisted Living Facility | 3101 E Bessemer Ave, Greensboro, NC 27405-7505 | 2007-03-28 |
| 1205976347 | Watlington Family Care | Assisted Living Facility | 1401 Sherrod Watlington Cir, Greensboro, NC 27406-9463 | 2007-02-07 |
| 1023160876 | Haven Group Homes | Assisted Living Facility | 3209 N Ohenry Blvd, Greensboro, NC 27405-3807 | 2007-01-18 |
| 1700905221 | Tracey L Johnson | Assisted Living Facility | 115 Thornton Ct, Greensboro, NC 27407-1429 | 2007-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265032320 | Healthy Moral Homes, LLC | Assisted Living Facility | 1513 Parks Village Rd, Zebulon, NC 27597-9580 | 2020-10-28 |
| 1578182556 | Connecting Dots Counseling Services | Assisted Living Facility | 2305 Woodbury Dr, Hillsborough, NC 27278-6620 | 2020-04-10 |
| 1629600770 | Safe Haven Facilities LLC | Assisted Living Facility | 412 Warren St, Williamston, NC 27892-2454 | 2020-02-06 |
| 1609406578 | True Nobility Care, LLC | Assisted Living Facility | 206 S Bend Dr, Durham, NC 27713-6163 | 2020-01-20 |
| 1376018895 | Abraham E Ketter | Assisted Living Facility | 4708 Twisted Oaks Rd Apt 104, Charlotte, NC 28212-7317 | 2018-10-11 |
| 1275014359 | Paris Washington | Assisted Living Facility | 3220 Atlas Dr, Charlotte, NC 28269-4193 | 2018-08-27 |
| 1396232195 | Southern Living for Seniors of Burnsville Nc LLC | Assisted Living Facility | 270 Love Fox Rd, Burnsville, NC 28714-9109 | 2018-04-17 |
| 1598123564 | Hills Dda Group Home | Assisted Living Facility | 2017 Eastridge Cir, Kinston, NC 28501-5224 | 2016-02-05 |
| 1013382811 | Joy and Devotion Family Services, Inc. | Assisted Living Facility | 5616 Old Garden Rd Apt 101, Wilmington, NC 28403-4435 | 2015-12-04 |
| 1831581289 | Duckworth Acquisitions LLC | Assisted Living Facility | 3341 Old Hwy 10 East, Nebo, NC 28761-6768 | 2015-02-23 |
| Find all providers with the same taxonomy | ||||
| City | GREENSBORO |
| Zip Code | 27401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.