COVENANT MEMORY CARE CENTER AT THE JOYCE GOLDENBERG CAMPUS, LLC (NPI# 1417437005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417437005 |
Entity Type | Organization |
Organization Name | COVENANT MEMORY CARE CENTER AT THE JOYCE GOLDENBERG CAMPUS, LLC |
Other Organization Name | COVENANT MEMORY CARE CENTER AND THE RESIDENCE |
Practice Address |
10075 Hillview Dr Pensacola FL 32514-5469 |
Mailing Address |
5041 N 12th Ave Pensacola FL 32504-8916 |
Practice Telephone | 8504843529 |
Practice Fax Number | 8882396554 |
Mailing Telephone | 8504332155 |
Mailing Fax Number | 8504787517 |
Enumeration Date | 2018-08-14 |
Last Update Date | 2018-08-14 |
Authorized Official Name | ODIN BERG (CHIEF FINANCIAL OFFICER) |
Authorized Official Telephone | 8504332155 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 310400000X | Assisted Living Facility | AL13110 | FL | Nursing & Custodial Care Facilities |
Other Name | Type Code |
---|---|
Covenant Memory Care Center and The Residence | Doing Business As Name - Organization |
Street Address |
10075 HILLVIEW DR |
City | PENSACOLA |
State | FL |
Zip Code | 32514-5469 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366507865 | Covenant Hospice Inc | Hospice, Inpatient | 10075 Hillview Dr, Pensacola, FL 32514-5469 | 2006-12-26 |
1659572915 | Covenant Hospice, Inc. | Pharmacy | 10075 Hillview Dr, Pensacola, FL 32514-5469 | 2007-05-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568920643 | Cameron Rae Mackey | Student in an Organized Health Care Education/Training Program | 9091 Aiway Dr, Apt 622, Pensacola, FL 32514 | 2019-03-07 |
1083182612 | B & B of Pensacola LLC | Home Health | 2024 E Olive Rd, Pensacola, FL 32514 | 2018-11-13 |
1902398423 | Chana Levy | Developmental Therapist | 10080 Hillview Dr # 387b, Pensacola, FL 32514 | 2018-05-31 |
1629407663 | James Daniel Langston | Registered Nurse | 8383 North Davie Highway, Pensacola, FL 32514 | 2013-11-08 |
1174956197 | Valerie Kuloba | Pharmacist | 9251 University Parkway, Pensacola, FL 32514 | 2013-08-13 |
1548550924 | Pamela Lynn Trammel | Nurse Practitioner | 8383 North Davis Hywy, West Florida Hospital, Pensacola, FL 32514 | 2011-04-19 |
1659609378 | Michael Smith | Physical Therapy Assistant | 10100 Hillveiw Dr., Pensacola, FL 32514 | 2009-11-19 |
1154582906 | Karen Buchanan Bailey | Dentist | 2322 Copter Road, Pensacola, FL 32514 | 2008-06-24 |
1811181985 | Sandra Paquingan Kloman | Registered Nurse | 9400 University Parkway #10c, Medical Professional Agency, Pensacola, FL 32514 | 2007-08-31 |
1083826523 | Renfroe Spinal Center LLC | Chiropractor | 1421 East Nine Mile Rd, Pensacola, FL 32514 | 2007-05-04 |
Find all providers in zip 32514 |
Taxonomy Code | 310400000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Assisted Living Facility |
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821617333 | Shelton Manor Inc | Assisted Living Facility | 9700 Pensacola Blvd, Pensacola, FL 32534-1242 | 2020-04-14 |
1831660240 | The Rhema House | Assisted Living Facility | 2910 Michael Dr, Pensacola, FL 32505-3999 | 2018-12-10 |
1033619093 | Prisyco Manor LLC | Assisted Living Facility | 8061 Groveland Ave, Pensacola, FL 32534-3551 | 2018-02-16 |
1578989695 | Grandview Retirement Center | Assisted Living Facility | 1706 E Olive Rd, Pensacola, FL 32514-7553 | 2014-03-13 |
1679998389 | House of Honor, LLC | Assisted Living Facility | 8090 Tippin Ave, Pensacola, FL 32514-6357 | 2014-03-04 |
1235551672 | Ashley Leggett | Assisted Living Facility | 1030 Jojo Rd, Pensacola, FL 32514-3235 | 2014-01-18 |
1255763256 | Extended Care Portfolio Florida Tenant, LLC | Assisted Living Facility | 5918 N Davis Hwy, Pensacola, FL 32503-2050 | 2013-08-01 |
1295082246 | Cooper-solice Inc Dba Asbury Place | Assisted Living Facility | 4916 Mobile Hwy, Pensacola, FL 32506-3230 | 2012-08-09 |
1619271525 | Northpointe Retirement Community | Assisted Living Facility | 5100 Northpointe Pkwy, Pensacola, FL 32514-7844 | 2011-01-06 |
1972807881 | Westpointe Retirement Community | Assisted Living Facility | 5101 Northpointe Pkwy, Pensacola, FL 32514-7846 | 2011-01-06 |
Find all providers in PENSACOLA |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.