Organization
COVENANT HEALTH SYSTEM
Active
Other names
Covenant Substance Abuse
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELINDA CLARK (CEO)
(806) 725-0579
Entity
Organization
Contact information
Practice address
4000 24TH ST, LUBBOCK, TX 79410-1894
(806) 725-1011
Mailing address
PO BOX 1201, LUBBOCK, TX 79408-1201
(806) 725-1011
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
000465
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH3291
SUBSTANCE ABUSE
TX
Enumeration date
05/23/2007
Last updated
10/14/2009
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