COVENANT 21ST CENTURY MINISTRIES, INC (NPI# 1508036054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508036054 |
| Entity Type | Organization |
| Organization Name | COVENANT 21ST CENTURY MINISTRIES, INC |
| Other Organization Name | COVENANT PLACE |
| Practice Address |
260 Filbert St Norfolk VA 23505-4410 |
| Mailing Address |
5301 Providence Rd Suite 20 Virginia Beach VA 23464-4128 |
| Practice Telephone | 7574932912 |
| Practice Fax Number | 7574932913 |
| Mailing Telephone | 7574932912 |
| Mailing Fax Number | 7574932913 |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2009-04-14 |
| Authorized Official Name | DR. PORTIA DENEEN RAWLES (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 7574932912 |
| Authorized Official Credential | PSY D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 80714001 | VA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1508036054 | 05 |
| Other Name | Type Code |
|---|---|
| Covenant Place | Doing Business As Name - Organization |
| Street Address |
260 FILBERT ST |
| City | NORFOLK |
| State | VA |
| Zip Code | 23505-4410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154844256 | Cassandra Shelton | Specialist/Technologist, Other | 100 Kingsley Lane, Norfolk, VA 23505 | 2017-07-20 |
| 1063942852 | Gabriela Marie Santiago | Specialist/Technologist | 7600 Victory Dr, Apt 3, Norfolk, VA 23505 | 2017-06-14 |
| 1144776725 | Amr Hassan | Pharmacist | 1610 W Little Creek Rd, Apt 204, Norfolk, VA 23505 | 2016-09-01 |
| 1992175095 | Heather Mitchell | Nurse Practitioner | 110 Kingsley Ln Ste 309, Norfolk, VA 23505 | 2015-10-01 |
| 1255710620 | Jessica Ann Kestranek | Dentist | 7400 Granby St Ste D, Norfolk, VA 23505 | 2015-05-19 |
| 1710375274 | Carla Toledo | Nurse Practitioner | 155 Kingsley Lane, Suite 400, Norfolk, VA 23505 | 2015-01-06 |
| 1417359746 | James Austin Valone Jr. | Ophthalmology | 1423 Runymede Rd, Norfolk, VA 23505 | 2014-09-18 |
| 1861813370 | Harris Teeter, LLC | Pharmacy | 7550 Granby Street, Norfolk, VA 23505 | 2013-12-31 |
| 1649549361 | Linda Horsey | Social Worker | 7510 Granby Street, Suite 6, Norfolk, VA 23505 | 2011-12-27 |
| 1679705164 | Carolyn Lee Kee | Nurse's Aide | 7403 Hampton Blvd, Norfolk, VA 23505 | 2009-08-17 |
| Find all providers in zip 23505 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679905269 | Rest Haven LLC | Community Based Residential Treatment Facility, Mental Illness | 1005 Bland St, Norfolk, VA 23513-3386 | 2013-08-06 |
| 1386802759 | Achievers House | Community Based Residential Treatment Facility, Mental Illness | 1702 Brown Ave, Norfolk, VA 23504-4405 | 2008-06-01 |
| 1720282858 | Paramount Youth Services | Community Based Residential Treatment Facility, Mental Illness | 1352 Hanson Ave, Norfolk, VA 23504-2965 | 2007-06-13 |
| 1912101049 | Paramount Youth Services | Community Based Residential Treatment Facility, Mental Illness | 2252 Barraud Ave, Norfolk, VA 23504-2624 | 2007-06-13 |
| 1245434752 | Paramount Youth Services | Community Based Residential Treatment Facility, Mental Illness | 238 W 30th St, Norfolk, VA 23504-1520 | 2007-06-11 |
| 1285838797 | Paramount Youth Services | Community Based Residential Treatment Facility, Mental Illness | 3115 Lorraine Ave, Norfolk, VA 23509-1127 | 2007-06-11 |
| 1326240300 | Bj Associates | Community Based Residential Treatment Facility, Mental Illness | 901 E Indian River Rd, Norfolk, VA 23523-1723 | 2007-06-02 |
| 1811023997 | Campbell House Inc | Community Based Residential Treatment Facility, Mental Illness | 2531 Vincent Ave, Norfolk, VA 23509-2339 | 2007-02-26 |
| 1639615198 | The Link Dual Recovery Program | Community Based Residential Treatment Facility, Mental Illness | 305 N 9th St, Norfolk, NE 68701-3915 | 2017-01-09 |
| 1326364696 | Purvis Network Inc. | Community Based Residential Treatment Facility, Mental Illness | 2829 Mapleton Ave, Norfolk, VA 23504-3721 | 2010-04-12 |
| Find all providers in NORFOLK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.