NPIMap

Organization Active NPI

Covenant Home Services

Doing business as CovenantCare Hospice

  • Community Based Hospice Care Agency
  • Turlock, CA
National Provider Identifier
1740626829
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
COVENANT HOME SERVICES
Doing business as
CovenantCare Hospice
Practice address
125 N Broadway Ste 1B
Turlock, CA 95380-4811
Phone
(209) 664-2550
Fax
(209) 664-2557
NPI assigned
May 16, 2013
Last updated
Apr 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Authorized official

Name
Elizabeth Malzahn
Title
Vice President of Health Services
Phone
(773) 878-4430

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X
Community Based Hospice Care Agency 251G00000X CA Primary

Addresses

Primary practice location

125 N Broadway Ste 1B
Turlock, CA 95380-4811

Mailing address

5700 Old Orchard Road
Skokie, IL 60077
Phone (773) 878-2295

Other names 1

  • CovenantCare Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131007000719 CA Part A Provider - Hospice 4688740582 Practice locations: Turlock, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740626829. Details of each certification follow.

Hospice certification: CCN 051614

Legal name
COVENANT HOME SERVICES
Doing business as
COVENANTCARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 9, 1993
Last certification
Jul 26, 2019
Ownership / control type
Non-Profit - Church
Organization structure
CorporationNon-profit
Incorporated
Aug 7, 2007 in IL
Enrollment address
125 N Broadway
Ste 1a
Turlock, CA 95380-4811

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Covenant Care HospiceCCN 051614 · All quality measures
Ownership
Non-Profit
Certified
Aug 9, 1993
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Covenanthome Services7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

125 N Broadway
Ste 1A
Turlock, CA 95380
Phone (209) 250-5200

1505 Geer Rd
Turlock, CA 95380
Phone (209) 664-2424

202 Campbell St
Geneva, IL 60134
Phone (630) 232-6908

431 Williamsburg Ave
Geneva, IL 60134
Phone (630) 845-0680

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
Janet G Hoffman Individual Corporate OfficerSecretary Apr 29, 2022
Covenant Living Communities & Services Organization, Skokie, IL Non-profit Operational/Managerial Control Dec 23, 1975
David Erickson Individual Corporate OfficerPresident/Ceo Jun 1, 2024
W-2 Managing EmployeePresident/Ceo Jun 1, 2024
Operational/Managerial ControlPresident/Ceo Jun 1, 2024
Janet S Creaney Individual Corporate OfficerChair Jul 24, 2020
Elizabeth Malzahn Individual Corporate OfficerSenior Vice President Jun 1, 2016
Corporate Director Jun 1, 2016
W-2 Managing EmployeeVice President Jun 1, 2016
Jeannie Justie Individual Corporate OfficerCfo Sep 20, 2020
W-2 Managing EmployeeCfo Sep 20, 2020
Operational/Managerial ControlCfo Sep 20, 2020
Covenant Retirement Services Organization, Skokie, IL Non-profit Operational/Managerial Control Sep 25, 2008
James C Knapp Individual OtherMedical Director Feb 6, 2024
Ronda Malmberg Individual W-2 Managing EmployeeAgency Administrator Jul 16, 2013
Lorene G Flewellen Individual Corporate OfficerVice Chair Apr 29, 2022

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Covenantcare at HomeSt Charles, IL, CCN 147618 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Aug 7, 2007
Sep 25, 2008
Covenantcare HospiceSt. Charles, IL, CCN 141639 Hospice 5% Or Greater Direct Ownership Interest May 6, 2011

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Covenant Home Services

    dba CovenantCare at Home

    • Home Health Agency
    • St Charles, IL
    • NPI 1679794143

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Covenant Home Services

    dba CovenantCare Hospice

    • Community Based Hospice Care Agency
    • St Charles, IL
    • NPI 1952615809

    5% Or Greater Direct Ownership Interest

    CMS ownership

Facilities with the same owner 16

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

View all 16

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1368662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1740626829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 OLD ORCHARD ROAD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60077",
            "telephone_number": "773-878-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N BROADWAY STE 1B",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953804811",
            "telephone_number": "209-664-2550",
            "fax_number": "209-664-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HOME SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-16",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "MALZAHN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "VICE PRESIDENT OF HEALTH SERVICES",
        "authorized_official_telephone_number": "773-878-4430"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CovenantCare Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CovenantCare Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.