# MY COVENANT PLACE BEHAVIORAL HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MY COVENANT PLACE BEHAVIORAL HEALTH
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1245941830
- **Legal business name:** MY COVENANT PLACE BEHAVIORAL HEALTH
- **Authorized official:** LATISHA CARTER (PRESIDENT/CEO)
- **Authorized official phone:** (410) 200-9290

## Contact information

- **Practice address:** 10632 LITTLE PATUXENT PKWY STE 314-D, COLUMBIA, MD 21044-3273
- **Practice address phone:** (410) 660-9190
- **Mailing address:** 10632 LITTLE PATUXENT PKWY STE 314-D, COLUMBIA, MD 21044-3273
- **Mailing address phone:** (410) 660-9190

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/06/2022
- **Last updated:** 12/06/2022