Organization
COVENANT BEHAVIORAL HEALTH RESIDENTIAL FACILITY.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADANE HAILE NIGANI BHPP (ADMINISTRATOR)
(623) 330-7509
Entity
Organization
Contact information
Practice address
5322 W SHUMWAY FARM RD, LAVEEN, AZ 85339-6925
(623) 330-7509
Mailing address
5322 W SHUMWAY FARM RD, LAVEEN, AZ 85339-6925
(623) 330-7509
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
Other
Enumeration date
05/10/2024
Last updated
12/13/2024
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