# COVENANT HOME HEALTH CARE AGENCY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Covenant Care Agency
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750093241
- **Authorized official:** OMONIYI MAUDE ANNIE RN (ADMINISTRATOR)
- **Authorized official phone:** (352) 405-7077

## Contact information

- **Practice address:** 1731 NW 6TH ST STE B1, GAINESVILLE, FL 32609-8515
- **Practice address phone:** (240) 581-2279
- **Practice address fax:** (407) 602-0015
- **Mailing address:** 1731 NW 6TH ST STE B1, GAINESVILLE, FL 32609-8515
- **Mailing address phone:** (240) 581-2279
- **Mailing address fax:** (407) 602-0015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/16/2022
- **Last updated:** 08/05/2024