| NPI | 1508036054 |
|---|---|
| Doing Business As | COVENANT PLACE |
| Entity Type | Organization |
| Authorized Contact | PORTIA DENEEN RAWLES Clinical Director 757-493-2912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA 80714001) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2009-04-14 |