Provider Demographics
NPI:1114380946
Name:COVENANT CARE TREATMENT SERVICES
Entity Type:Organization
Organization Name:COVENANT CARE TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAE
Authorized Official - Middle Name:
Authorized Official - Last Name:FINDLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-422-1143
Mailing Address - Street 1:601 NORTH DIXIE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 NORTH DIXIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462
Practice Address - Country:US
Practice Address - Phone:754-422-1143
Practice Address - Fax:954-746-8231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty