Organization
MY COVENANT PLACE BEHAVIORAL HEALTH
Active
Parent organization
MY COVENANT PLACE BEHAVIORAL HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
MY COVENANT PLACE BEHAVIORAL HEALTH
Authorized official
LATISHA CARTER (PRESIDENT/CEO)
(410) 660-9190
Entity
Organization
Contact information
Practice address
5109 YORK ROAD, SUITE C- 2ND FLOOR, BALTIMORE, MD 21212-2121
(443) 759-3355
Mailing address
5109 YORK RD, SUITE C, 2ND FLOOR, BALTIMORE, MD 21212-4399
(443) 759-3355
(443) 990-0009
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/28/2022
Last updated
12/16/2022
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