Organization
COVENANT COMMUNITY CARE, INC.
Active
Other names
Waterman
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA GRIEBEL CHAVEZ (CFO)
(313) 554-0485
Entity
Organization
Contact information
Practice address
1700 WATERMAN ST, DETROIT, MI 48209-2022
(313) 841-1612
(313) 554-1918
Mailing address
559 W GRAND BLVD, DETROIT, MI 48216-2200
(313) 554-0485
(313) 554-3885
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
4704195855
MI
Other
Enumeration date
04/07/2009
Last updated
04/10/2023
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