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COVENANT VILLAGE NPI 1871822825


NPI Information

NPI: 1871822825
Provider Name: COVENANT VILLAGE
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 34D1078140

Address:
1351 ROBINWOOD RD
GASTONIA, NC
ZIP 28054
Phone: (704) 867-2319
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COVENANT VILLAGE is an assisted living facility in Gastonia, NC. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. COVENANT VILLAGE NPI is 1871822825. The provider is registered as an organization entity type.

The provider's business location address is:

1351 ROBINWOOD RD
GASTONIA, NC
ZIP 28054-693
Phone: (704) 867-2319
Fax: (704) 867-4442

The provider's authorized official is Judy Holcomb .
The authorized official title is Director Of Nursing and has the following contact phone number (704) 867-2319.

The CLIA number assigned to this NPI record is 34D1078140 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/21/2009 and was last updated on 12/21/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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