Provider Demographics
NPI:1275070013
Name:COVENANT HOMEMAKERS AND COMPANIONS LLC
Entity Type:Organization
Organization Name:COVENANT HOMEMAKERS AND COMPANIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:VICKERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-787-2235
Mailing Address - Street 1:5010 CLAYMORE DR
Mailing Address - Street 2:UNIT#203
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-8173
Mailing Address - Country:US
Mailing Address - Phone:813-787-2235
Mailing Address - Fax:
Practice Address - Street 1:5010 CLAYMORE DR
Practice Address - Street 2:UNIT#203
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-8173
Practice Address - Country:US
Practice Address - Phone:813-787-2235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health