Provider Demographics
NPI:1912459876
Name:COVENANT CAREGIVERS, LLC
Entity Type:Organization
Organization Name:COVENANT CAREGIVERS, LLC
Other - Org Name:COVENANT CAREGIVERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-856-5660
Mailing Address - Street 1:PO BOX 1481
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39130-1481
Mailing Address - Country:US
Mailing Address - Phone:601-856-5660
Mailing Address - Fax:601-856-5709
Practice Address - Street 1:930 EBENEZER BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110
Practice Address - Country:US
Practice Address - Phone:601-856-5660
Practice Address - Fax:601-856-5709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care