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General NPI Number Information
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NPI Number | 1083321863
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Entity Type | Organization
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Legal Business Name | COVENANT BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 11/01/2022
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 1045 DIXIE HWY
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City | CHICAGO HEIGHTS
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State | IL
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Zip | 60411-2622
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Country | US
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Telephone | 708-964-7983
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Fax |
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Provider Business Mailing Address
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Address Line | 1045 DIXIE HWY
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City | CHICAGO HEIGHTS
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State | IL
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Zip | 60411-2622
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ADENIKE AKOREDE
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Credential |
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Telephone | 708-964-7983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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