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COVENANT LIVING OF FLORIDA INC. NPI 1083719751


NPI Information

NPI: 1083719751
Provider Name: COVENANT LIVING OF FLORIDA, INC.

Doing Business As: COVENANT VILLAGE CARE CENTER

Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization

CLIA Number: 10D0890984

Address:
9215 W BROWARD BLVD
PLANTATION, FL
ZIP 33324
Phone: (954) 472-2860
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COVENANT LIVING OF FLORIDA, INC. is a skilled nursing facility in Plantation, FL. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. COVENANT LIVING OF FLORIDA, INC. NPI is 1083719751. The provider is registered as an organization entity type.
The provider Is Doing Business As Covenant Village Care Center.

The provider's business location address is:

9215 W BROWARD BLVD
PLANTATION, FL
ZIP 33324-404
Phone: (954) 472-2860
Fax: (954) 472-5934

The provider's authorized official is Elizabeth Malzahn .
The authorized official title is Vice President Of Health Services and has the following contact phone number (773) 878-4430.

The CLIA number assigned to this NPI record is 10D0890984 - skilled nursing/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/14/2006 and was last updated on 1/27/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1314000000XSkilled Nursing FacilitySNF11080961FLORIDAYes
2314000000XSkilled Nursing FacilityNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1210188MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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