| Covenant Community Care, Inc. | |
|
17625 Joy Rd Detroit MI 48228-1999 | |
| (313) 446-8800 | |
| (313) 446-8810 |
| Full Name | Covenant Community Care, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 17625 Joy Rd, Detroit, Michigan |
| Authorized Official Name and Position | Anna Griebel Chavez (CFO) |
| Authorized Official Contact | 3135540485 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Community Care, Inc. 559 W Grand Blvd Detroit MI 48216-2200 Ph: (313) 554-0485 | Covenant Community Care, Inc. 17625 Joy Rd Detroit MI 48228-1999 Ph: (313) 446-8800 |
| NPI Number | 1558792937 |
|---|---|
| Provider Enumeration Date | 12/10/2013 |
| Last Update Date | 11/01/2023 |
| Medicare PECOS PAC ID | 1254393549 |
|---|---|
| Medicare Enrollment ID | O20140331001682 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558792937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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