Covenant Memory Care Center at the Joyce Goldenberg Campus, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL13110 Issued in FL

Legal business name

COVENANT MEMORY CARE CENTER AT THE JOYCE GOLDENBERG CAMPUS, LLC

Practice address

10075 Hillview Dr
Pensacola, FL 32514-5469

Phone

(850) 484-3529

Fax

(888) 239-6554

NPI assigned

Aug 14, 2018

Organization subpart

No

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

Authorized official

Name

Odin Berg

Title

Chief Financial Officer

Phone

(850) 433-2155

Specialties & licenses 1

Addresses

Other names 1

• Covenant Memory Care Center and The Residence Doing business as

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1417437005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5041 N 12TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048916",
            "telephone_number": "850-433-2155",
            "fax_number": "850-478-7517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10075 HILLVIEW DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145469",
            "telephone_number": "850-484-3529",
            "fax_number": "888-239-6554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT MEMORY CARE CENTER AT THE JOYCE GOLDENBERG CAMPUS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "ODIN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "850-433-2155"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL13110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Memory Care Center and The Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Covenant Hospice Inc
• Covenant Hospice Inc
• Covenant Hospice Inpatient & Palliative Care Center
• Covenant Hospice, Inc.
• Covenant Hospice,Inc
• Covenant Palliative Care Services, LLC
• Robert Frederick Cowan, DC, CAP
• Bonnie Ellen Cowen
• Rebecca Cower, PAC
• Antonio Cox

• Assisted Living Facility in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.