Organization
COVENANT COMMUNITY CARE, INC.
Active
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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