Organization
COVENANT RECOVERY CENTER LLC
Active
Other names
Covenant Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH DEAN WILLIS MD (SOLE MEMBER)
(256) 882-2003
Entity
Organization
Contact information
Practice address
3007 MEMORIAL PKWY SW STE C, HUNTSVILLE, AL 35801-5394
(256) 882-2003
(256) 705-4630
Mailing address
3007 MEMORIAL PKWY SW STE C, HUNTSVILLE, AL 35801-5394
(256) 882-2003
(256) 705-4630
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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