Provider Demographics
NPI:1487411260
Name:COVENANT HEALTH STAFFING LLC
Entity type:Organization
Organization Name:COVENANT HEALTH STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:D
Authorized Official - Last Name:AJALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-725-7478
Mailing Address - Street 1:193 CREEKSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-1056
Mailing Address - Country:US
Mailing Address - Phone:732-725-7478
Mailing Address - Fax:732-231-5275
Practice Address - Street 1:193 CREEKSIDE WAY
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-1056
Practice Address - Country:US
Practice Address - Phone:732-725-7478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care