Organization
COVENANT HOUSE INC
Active
Other names
Covenant House Health and Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN DENISE STUKES (CEO)
(215) 844-1020
Entity
Organization
Contact information
Practice address
8127 STENTON AVE, PHILADELPHIA, PA 19150-3530
(267) 331-9832
(267) 331-9932
Mailing address
8127 STENTON AVE, PHILADELPHIA, PA 19150-3530
(267) 331-9832
(267) 331-9932
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
PA
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Enumeration date
02/28/2014
Last updated
09/20/2023
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