NPIMap

Organization Active NPI

Home Health Care, Inc.

Doing business as Covenant Home Health

  • Home Health Agency
  • Phoenix, AZ
National Provider Identifier
1093025439
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA4941 Issued in AZ
Legal business name
HOME HEALTH CARE, INC.
Doing business as
Covenant Home Health
Practice address
11830 N 19TH Ave
Phoenix, AZ 85029-3519
Phone
(602) 443-5439
NPI assigned
Oct 19, 2010
Last updated
Dec 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jami Fae Gross
Title
Executive Director
Phone
(602) 443-5439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA4941 AZ Primary

Addresses

Primary practice location

11830 N 19TH Ave
Phoenix, AZ 85029-3519

Mailing address

11830 N 19TH Ave
Phoenix, AZ 85029-3519
Phone (602) 443-5439

Other names 1

  • Covenant Home Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110316001061 AZ Part A Provider - Home Health Agency 6305818980 Practice locations: Phoenix, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093025439. Details of each certification follow.

Home health agency certification: CCN 037410

Legal name
HOME HEALTH CARE, INC.
Doing business as
COVENANT HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 21, 2012
Last certification
Feb 4, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 12, 1997 in MT
Enrollment address
11830 N 19TH Ave
Phoenix, AZ 85029-3519
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Covenant Home HealthCCN 037410 · All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
May 21, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory

Locations

1903 S Russell St
#1
Missoula, MT 59801
Phone (406) 541-1800

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Covenant Health Network Organization, Phoenix, AZ Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2013 24%
Christian Care Managment Inc Organization, Phoenix, AZ Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 13, 2018 76%
Jami Gross Individual Contracted Managing Employee Dec 13, 2018
Corporate Director Dec 13, 2018
Scott Motyka Individual Corporate Director Oct 1, 2023
George Ortega Individual Corporate Director Oct 1, 2023
Alan Hieb Individual Corporate Director Jan 22, 2019
Jon Scott Williams Individual Corporate OfficerPresident Oct 1, 2023
Corporate Director Jan 22, 2019
Matthew Luger Individual Corporate OfficerVice President Oct 1, 2023
Corporate Director Jan 1, 2013
Rena Phillips Individual Corporate Director Oct 1, 2023
Kathleen Condon Individual Corporate Director Jan 22, 2019

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 10

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1093025439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11830 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293519",
            "telephone_number": "602-443-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11830 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293519",
            "telephone_number": "602-443-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-19",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "JAMI",
        "authorized_official_middle_name": "FAE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "602-443-5439"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "HHA4941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Covenant Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.