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CH0537520 COVENANT COMMUNITY CARE, INC. (Active)
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Main Details
Name
COVENANT COMMUNITY CARE, INC.
Subdivision Name
Covenant Michigan Avenue Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010460
340B ID
CH0537520
Grant Number
H80CS08738
Additional Details
Current Program Status
Active
Registration Date
9/7/2007
Participating Start Date
10/1/2007
Participating Approval Date
9/10/2007
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Covenant Community Care, Inc.
Anna Chavez, Chief Financial Officer
(313) 554-0485
Primary Contact
Covenant Community Care
Deborah Salazar, Controller
(313) 625-1377
Addresses
Street Address
5716 Michigan Ave
Detroit, MI 48210-3039
Billing Address
COVENANT COMMUNITY CARE, INC.
559 WEST GRAND BLVD
DETROIT, MI 48216
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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6/22/11 UPDATED PHY ADD (WAS 559 W. GRAND BLVD), ADDED BILL-TO
06/22/2011
May 2025
May 2025
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