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Organization

MY COVENANT PLACE BEHAVIORAL HEALTH

Active
Parent organization
MY COVENANT PLACE
Organization subpart
Yes

Provider details

NPI number
Legal business name
MY COVENANT PLACE
Authorized official
LATISHA CARTER (CEO)
(301) 577-7307
Entity
Organization

Contact information

Practice address
9701 APOLLO DR STE 411, LARGO, MD 20774-4783
(443) 759-3355
(301) 476-0076
Mailing address
10630 LITTLE PATUXENT PKWY STE 113, COLUMBIA, MD 21044-6225
(410) 200-9192
(301) 476-0076

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Enumeration date
03/23/2022
Last updated
01/10/2023
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