COVENANT COMMUNITY CARE, INC (NPI# 1770852634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770852634 |
| Entity Type | Organization |
| Organization Name | COVENANT COMMUNITY CARE, INC |
| Other Organization Name | FAMILY DENTAL CENTER |
| Practice Address |
5716 Michigan Ave Detroit MI 48210-3039 |
| Mailing Address |
559 W Grand Blvd Detroit MI 48216-2200 |
| Practice Telephone | 3135543880 |
| Practice Fax Number | 3138993550 |
| Mailing Telephone | 3132280217 |
| Mailing Fax Number | 3132280204 |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-22 |
| Authorized Official Name | MR. PAUL PROPSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3135540485 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Family Dental Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205394814 | Covenant Community Care, Inc | Clinic/Center | 32932 Warren Rd, Westland, MI 48185-3095 | 2019-03-04 |
| 1558792937 | Covenant Community Care, Inc | Clinic/Center | 18917 Joy Rd, Detroit, MI 48228-3050 | 2013-12-10 |
| 1730465162 | Covenant Community Care, Inc | Clinic/Center | 16411 Curtis St, Detroit, MI 48235-3202 | 2011-10-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COVENANT COMMUNITY CARE, INC. | 559 W Grand Blvd, Detroit, MI 48216-2200 |
| Street Address |
5716 MICHIGAN AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48210-3039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205827573 | Lisa J Mcintosh | Obstetrics & Gynecology | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2005-11-04 |
| 1891326625 | Gabriella Jamie Sanford | Social Worker | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2020-01-30 |
| 1972143782 | Joanna Veronica Dimas | Social Worker | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2020-01-09 |
| 1720621279 | Rachel Campbell | Nurse Practitioner | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-10-28 |
| 1326699752 | Carmensita J Buentello | Counselor | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-09-26 |
| 1316598329 | Disheka Denise Beverly-daniels | Social Worker | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-09-23 |
| 1912552449 | Katharine Nicole Marquez | Social Worker | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-08-01 |
| 1174183057 | Katherine Byl | Physician Assistant | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-06-13 |
| 1760955124 | Hawa A Haji-hassan | Student in an Organized Health Care Education/Training Program | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-01-09 |
| 1962975631 | Emma Jean Urbain | Social Worker | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-01-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518517606 | Southwest Solutions | Counselor | 5716 Michigan, Detroit, MI 48210 | 2019-09-19 |
| 1942676150 | Audrey Hall | Case Manager/Care Coordinator | 6576 Woodrow St, Detroit, MI 48210 | 2015-08-12 |
| 1952705147 | Barbara Denise Mccowin-west | Technician, Other | 6900 Mcgraw, Detroit, MI 48210 | 2014-10-16 |
| 1922259456 | Dawn Marie Sanderson | Counselor | 5613 Livernois, Detroit, MI 48210 | 2008-10-02 |
| 1366552804 | American Indian Health and Family Services of Southeastern Mi Inc | In Home Supportive Care | 4880 Lawndalestreet, Detroit, MI 48210 | 2006-08-30 |
| 1912950163 | Irwin Rabinowitz | Pharmacist | Junction Clinic Pharmacy 4771 Michigan Ave., Detroit, MI 48210 | 2006-05-18 |
| 1538305909 | Barbara Ann Menzies-williams | Internal Medicine | 6550 W Warren Ave, Detroit, MI 48210 | 2009-01-06 |
| 1760678437 | Clement T Piaskowski | Optometrist | 7433 Michigan Ave, Detroit, MI 48210 | 2007-09-17 |
| 1083804173 | Detroit Medical Centre | General Acute Care Hospital | 4201 St. Antoine, Detroit, MI 48210 | 2007-07-26 |
| 1205030277 | Renaissance Dental PC | Dentist | 7330 W Warren Ave, Detroit, MI 48210-1041 | 2007-06-13 |
| Find all providers in zip 48210 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679195721 | Family Medical Center of Michigan,inc | Clinic/Center | 2740 Collingwood St Ste 100, Detroit, MI 48206-1473 | 2020-05-12 |
| 1154892958 | Family Medical Center of Michigan, Inc | Clinic/Center | 2425 Tuxedo St Rm 115, Detroit, MI 48206-1222 | 2018-12-06 |
| 1801361464 | Detroit Health Care for The Homeless | Clinic/Center | 1355 Oakman Blvd, Detroit, MI 48238-2849 | 2018-10-10 |
| 1306329800 | Family Medical Center of Michigan,inc | Clinic/Center | 15531 Linwood St Rm 102, Detroit, MI 48238-1465 | 2018-09-11 |
| 1982072963 | Detroit Healthcare for The Homeless | Clinic/Center | 1234 Porter St, Detroit, MI 48226-2407 | 2015-09-09 |
| 1851554034 | Detroit Community Health Connection, Inc | Clinic/Center | 111 W 7 Mile Rd, Detroit, MI 48203-1968 | 2008-07-08 |
| 1396839981 | Detroit Health Care for The Homeless | Clinic/Center | 60 E. Warren, Detroit, MI 48201 | 2006-10-03 |
| 1285735845 | Detroit Health Care for The Homeless | Clinic/Center | 20548 Fenkell, Detroit, MI 48223 | 2006-09-26 |
| 1275576886 | Ronaldo B Supena | Clinic/Center | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2006-06-13 |
| 1033109244 | Community Health and Social Services Center, Inc | Clinic/Center | 7436 Woodward Ave, Detroit, MI 48202-3100 | 2005-10-27 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.