Provider Demographics
NPI:1447957410
Name:COVENANT BEHAVIOR HEALTHCARE SERVICES
Entity type:Organization
Organization Name:COVENANT BEHAVIOR HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:757-749-7985
Mailing Address - Street 1:1749 PATTIE LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-1946
Mailing Address - Country:US
Mailing Address - Phone:757-749-7985
Mailing Address - Fax:757-228-3619
Practice Address - Street 1:1749 PATTIE LN
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-1946
Practice Address - Country:US
Practice Address - Phone:757-749-7985
Practice Address - Fax:757-228-3619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services