Provider Demographics
NPI:1649392127
Name:COVENANT COVE FAMILY CARE HOME, INC
Entity type:Organization
Organization Name:COVENANT COVE FAMILY CARE HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ALFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-848-1224
Mailing Address - Street 1:1189 GAINEY RD
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-6857
Mailing Address - Country:US
Mailing Address - Phone:910-848-1224
Mailing Address - Fax:910-848-0129
Practice Address - Street 1:1189 GAINEY RD
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-6857
Practice Address - Country:US
Practice Address - Phone:910-848-1224
Practice Address - Fax:910-848-0129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home