| NPI | 1669776092 |
|---|---|
| Doing Business As | COVENANT OF LOVE COMMUNITY SERVICES |
| Entity Type | Organization |
| Authorized Contact | CHARLENE WHITE BYNUM President, Administrator, Cadc 702-810-4830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 5464TLF-1) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: NV 5061AGC-1) |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2010-12-28 |