NPIMap

Organization Active NPI

Covenant Health System

Doing business as Covenant Substance Abuse

  • Substance Abuse Rehabilitation Facility
  • Lubbock, TX
National Provider Identifier
1629288238
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
000465 Issued in TX
Legal business name
COVENANT HEALTH SYSTEM
Doing business as
Covenant Substance Abuse
Practice address
4000 24TH St
Lubbock, TX 79410-1894
Phone
(806) 725-1011
NPI assigned
May 23, 2007
Last updated
Oct 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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

Authorized official

Name
Mrs. Melinda Clark
Title
Ceo
Phone
(806) 725-0579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 000465 TX Primary

Addresses

Primary practice location

4000 24TH St
Lubbock, TX 79410-1894

Mailing address

PO Box 1201
Lubbock, TX 79408-1201
Phone (806) 725-1011

Other identifiers 1

IdentifierTypeStateIssuer
HH3291OtherTXSUBSTANCE ABUSE

Other names 1

  • Covenant Substance Abuse Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CHC Mob11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255478400000",
    "number": "1629288238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1201",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794081201",
            "telephone_number": "806-725-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101894",
            "telephone_number": "806-725-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2009-10-14",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "806-725-0579",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "TX",
            "license": "000465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBSTANCE ABUSE",
            "identifier": "HH3291",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Substance Abuse",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.