| Covenant Of Love Community Services | |
|
408 Eldorado Hills Ct Las Vegas NV 89110-5646 | |
| (702) 810-4830 | |
| (702) 255-7766 |
| Full Name | Covenant Of Love Community Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 408 Eldorado Hills Ct, Las Vegas, Nevada |
| Authorized Official Name and Position | Charlene White Bynum (PRESIDENT, ADMINISTRATOR, CADC) |
| Authorized Official Contact | 7028104830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Of Love Community Services 408 Eldorado Hills Ct Las Vegas NV 89110-5646 Ph: (702) 810-4830 | Covenant Of Love Community Services 408 Eldorado Hills Ct Las Vegas NV 89110-5646 Ph: (702) 810-4830 |
| NPI Number | 1669776092 |
|---|---|
| Provider Enumeration Date | 12/28/2010 |
| Last Update Date | 12/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669776092 | NPI | - | NPPES |
| 251S00000X | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5464TLF-1 (Nevada) | Primary |
| 302F00000X | Exclusive Provider Organization | 5061AGC-1 (Nevada) | Secondary |
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