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General NPI Number Information
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NPI Number | 1912459876
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Entity Type | Organization
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Legal Business Name | COVENANT CAREGIVERS, LLC
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 930 EBENEZER BLVD SUITE C
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City | MADISON
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State | MS
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Zip | 39110
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Country | US
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Telephone | 601-856-5660
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Fax | 601-856-5709
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Provider Business Mailing Address
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Address Line | PO BOX 1481
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City | MADISON
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State | MS
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Zip | 39130-1481
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Country | US
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Telephone | 601-856-5660
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Fax | 601-856-5709
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Authorized Official
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Title or Position | OWNER
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Name | MR. MIKE DAVIS
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Credential |
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Telephone | 601-856-5660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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