| NPI | 1699190561 |
|---|---|
| Doing Business As | COVENANT HOUSE HEALTH AND DENTAL |
| Entity Type | Organization |
| Authorized Contact | SUSAN DENISE STUKES CEO 215-844-1020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2023-09-20 |