Provider Demographics
NPI:1487687273
Name:COVE BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:COVE BEHAVIORAL HEALTH, INC.
Other - Org Name:DACCO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:OBREGON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-384-4161
Mailing Address - Street 1:4422 E COLUMBUS DRIVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605
Mailing Address - Country:US
Mailing Address - Phone:813-384-4216
Mailing Address - Fax:813-623-3730
Practice Address - Street 1:4422 E COLUMBUS DRIVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605
Practice Address - Country:US
Practice Address - Phone:813-384-4216
Practice Address - Fax:813-623-3730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 261QM0801X
FL858012643687251V00000X
FL858012643687C2251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060650200Medicaid
FL060650203Medicaid
FL060650202Medicaid
FL913334800Medicaid
FL060650204Medicaid