Organization
COVENANT HOUSE INC
Active
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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