Organization · Type 2 NPI

Covenant Living West

Skilled Nursing Facility · Spring Valley, CA

NPI number 1649375403 Active

Practice location

325 Kempton St
Spring Valley, CA 91977-5810

Fax (619) 479-2337

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility	314000000X	090000080 (CA)
Skilled Nursing Facility Primary	314000000X	None listed

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

12 other providers at this address

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NPI record

NPI: 1649375403
Entity type: Organization (Type 2)
Issued: Sep 14, 2006
Last updated: Jul 30, 2019
Status: Active

Other names

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Mount Miguel Care Center · doing business as
Mount Miguel Covenant Village Health Facility · doing business as
Mount Miguel Covenant Village Health Facility · doing business as

Authorized official

Elizabeth Malzahn
Vice President of Health Services
(773) 878-4430

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1649375403

Covenant Living West's National Provider Identifier is 1649375403, issued on Sep 14, 2006. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Spring Valley, CA. The record was last updated on Jul 30, 2019.