| NPI | 1053588988 |
|---|---|
| Doing Business As | COVENANT HOUSE |
| Entity Type | Organization |
| Authorized Contact | DAVID J DAVIS Medical Director 212-613-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2017-06-09 |