Provider Demographics
NPI:1063264216
Name:COVENANT CARE INCORPORATED
Entity type:Organization
Organization Name:COVENANT CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KARZON
Authorized Official - Suffix:SR
Authorized Official - Credentials:DSP
Authorized Official - Phone:240-330-3518
Mailing Address - Street 1:539 3RD ST SW
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-4022
Mailing Address - Country:US
Mailing Address - Phone:240-330-3518
Mailing Address - Fax:
Practice Address - Street 1:539 3RD ST SW
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-4022
Practice Address - Country:US
Practice Address - Phone:240-330-3518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care