Organization
COVENANT HOUSE, INC
Active
Other names
Covenant House Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN DENISE STUKES (CHIEF EXECUTIVE OFFICER)
(215) 844-1020
Entity
Organization
Contact information
Practice address
8125 STENTON AVE, PHILADELPHIA, PA 19150-3530
(215) 248-7560
(215) 248-7564
Mailing address
8125 STENTON AVE, PHILADELPHIA, PA 19150-3530
(215) 248-7560
(215) 248-7564
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
032220
PA
Other
Enumeration date
09/30/2009
Last updated
12/20/2023
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