Covenant Recovery Center LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

COVENANT RECOVERY CENTER LLC

Doing business as

Covenant Recovery Center

Practice address

3007 Memorial Pkwy SW Ste C
Huntsville, AL 35801-5394

Phone

(256) 882-2003

Fax

(256) 705-4630

NPI assigned

Jan 9, 2018

Last updated

Jan 9, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kenneth Dean Willis, MDNPI 1053486704

Title

Sole Member

Phone

(256) 882-2003

Specialties & licenses 1

Addresses

Other names 1

• Covenant Recovery Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Dean Willis, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Huntsville, AL
  • NPI 1053486704
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515456000000",
    "number": "1366959561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 MEMORIAL PKWY SW STE C",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015394",
            "telephone_number": "256-882-2003",
            "fax_number": "256-705-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 MEMORIAL PKWY SW STE C",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015394",
            "telephone_number": "256-882-2003",
            "fax_number": "256-705-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT RECOVERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-09",
        "last_updated": "2018-01-09",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "256-882-2003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alisa Courtney, DPT
• Cynthia Courtney
• Diego Eduardo Covarrubias, LMT
• Cove Chiropractic Inc.
• Covenant Pain Therapies Center, Inc (Covenant Pain Center)
• Samantha Coveney, RD
• Coverd Dietetics, LLC
• Nakiesha Cowan-Richardson
• Kori R Cowan, LPC
• Wesley Cowan

• Addiction (Substance Use Disorder) Counselor in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Addiction (Substance Use Disorder) Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.