| The Covenant House | |
|
201 Fairoaks Ct Stockbridge GA 30281-1192 | |
| (404) 903-7419 | |
| Not Available |
| Full Name | The Covenant House |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 201 Fairoaks Ct, Stockbridge, Georgia |
| Authorized Official Name and Position | Edelene Mcneal (OWNER) |
| Authorized Official Contact | 4049037419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Covenant House 201 Fairoaks Ct Stockbridge GA 30281-1192 Ph: () - | The Covenant House 201 Fairoaks Ct Stockbridge GA 30281-1192 Ph: (404) 903-7419 |
| NPI Number | 1356679039 |
|---|---|
| Provider Enumeration Date | 11/18/2009 |
| Last Update Date | 11/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356679039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Secondary |
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