| My Covenant Place Behavioral Health | |
|
5109 York Road Suite C- 2nd Floor Baltimore MD 21212-2121 | |
| (443) 759-3355 | |
| Not Available |
| Full Name | My Covenant Place Behavioral Health |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 5109 York Road, Baltimore, Maryland |
| Authorized Official Name and Position | Latisha Carter (PRESIDENT/CEO) |
| Authorized Official Contact | 4106609190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Covenant Place Behavioral Health 5109 York Rd Suite C, 2nd Floor Baltimore MD 21212-4399 Ph: (443) 759-3355 | My Covenant Place Behavioral Health 5109 York Road Suite C- 2nd Floor Baltimore MD 21212-2121 Ph: (443) 759-3355 |
| NPI Number | 1780394031 |
|---|---|
| Provider Enumeration Date | 11/28/2022 |
| Last Update Date | 12/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780394031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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