NPIMap

Organization Active NPI

Covenant House Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
National Provider Identifier
1720361447
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
032220 Issued in PA
Legal business name
COVENANT HOUSE INC.
Practice address
251 E Bringhurst St
Philadelphia, PA 19144-1719
Phone
(215) 844-1020
Fax
(215) 844-2702
NPI assigned
Sep 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Susan Denise Stukes
Title
Chief Executive Officer
Phone
(215) 844-1020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 032220 PA Primary

Addresses

Primary practice location

251 E Bringhurst St
Philadelphia, PA 19144-1719

Mailing address

251 E Bringhurst St
Philadelphia, PA 19144-1719
Phone (215) 844-1020

Other identifiers 2

IdentifierTypeStateIssuer
00652OtherPAHEALTH PARTNERS
1007564460003MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Covenant House HLTH SVC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1720361447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E BRINGHURST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191441719",
            "telephone_number": "215-844-1020",
            "fax_number": "215-844-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E BRINGHURST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191441719",
            "telephone_number": "215-844-1020",
            "fax_number": "215-844-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HOUSE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "STUKES",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "215-844-1020",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "PA",
            "license": "032220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "00652",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007564460003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.