Provider Demographics
NPI:1386287472
Name:COVENANT PRP, LLC
Entity type:Organization
Organization Name:COVENANT PRP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FOLAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALOBA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MSN, CRNP-PMH
Authorized Official - Phone:301-363-0707
Mailing Address - Street 1:2607 BOX TREE DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-9306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3415 HAMILTON ST STE 6
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3953
Practice Address - Country:US
Practice Address - Phone:301-363-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Single Specialty