| My Covenant Place Behavioral Health | |
|
9701 Apollo Dr Ste 411 Largo MD 20774-4783 | |
| (443) 759-3355 | |
| (301) 476-0076 |
| Full Name | My Covenant Place Behavioral Health |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 9701 Apollo Dr Ste 411, Largo, Maryland |
| Authorized Official Name and Position | Latisha Carter (CEO) |
| Authorized Official Contact | 3015777307 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Covenant Place Behavioral Health 10630 Little Patuxent Pkwy Ste 113 Columbia MD 21044-6225 Ph: (410) 200-9192 | My Covenant Place Behavioral Health 9701 Apollo Dr Ste 411 Largo MD 20774-4783 Ph: (443) 759-3355 |
| NPI Number | 1558010603 |
|---|---|
| Provider Enumeration Date | 03/23/2022 |
| Last Update Date | 01/10/2023 |
| Certification Date | 01/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558010603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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