Organization
THE COVENANT HOUSE
Active
Organization
THE COVENANT HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDELENE MCNEAL (OWNER)
(404) 903-7419
Entity
Organization
Contact information
Practice address
201 FAIROAKS CT, STOCKBRIDGE, GA 30281-1192
(404) 903-7419
Mailing address
201 FAIROAKS CT, STOCKBRIDGE, GA 30281-1192
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
11/18/2009
Last updated
11/18/2009
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