| NPI | 1073834818 |
|---|---|
| Other Name | COVENANT WOODWARD AVENUE |
| Entity Type | Organization |
| Authorized Contact | JOSLYN PETTWAY Chief Executive Officer 313-554-0485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: MI 4704195855) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2022-05-18 |