Organization
COVENANT COMMUNITY CARE, INC.
Active
Other names
Covenant Woodward Avenue
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOSLYN PETTWAY (CHIEF EXECUTIVE OFFICER)
(313) 554-0485
Entity
Organization
Contact information
Practice address
27776 WOODWARD AVE, ROYAL OAK, MI 48067-0930
(248) 556-4900
(248) 556-4950
Mailing address
559 W GRAND BLVD, DETROIT, MI 48216-2200
(313) 554-0485
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
4704195855
MI
Other
Enumeration date
06/16/2010
Last updated
05/18/2022
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