Provider Demographics
NPI:1902458722
Name:COVENANT HOME HEALTH CARE 4, LLC
Entity type:Organization
Organization Name:COVENANT HOME HEALTH CARE 4, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HITCHCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-433-2155
Mailing Address - Street 1:5101 N 12TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8928
Mailing Address - Country:US
Mailing Address - Phone:850-433-2155
Mailing Address - Fax:
Practice Address - Street 1:8206 PHILIPS HWY UNIT 8
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-1245
Practice Address - Country:US
Practice Address - Phone:850-433-2155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COVENANT HEALTH AND COMMUNITY SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-11
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health