Organization Name: | COVENANT HOSPICE INC |
NPI Number: | 1093870594 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DALE O KNEE (PRESIDENT CEO) |
Mailing Address: | 4215 Kelson Ave Suite E Marianna |
State: | FL US |
Postal Code: | 324466502 |
Phone Number: | 8504828520 |
Fax Number: | 8504828985 |
NPI Enumeration Date: | 12/26/2006 |
NPI Last Update Date: | 06/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 5025095 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |