MEDICARE: COVENANT HOUSE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)	032220	PA

General Provider Information

NPI Number	:	1528392008
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COVENANT HOUSE, INC

Provider Business Mailing Address
First Line	:	8125 STENTON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19150-3530
Country	:	US
Telephone Number	:	215-248-7560
Fax Number	:	215-248-7564

Provider Business Practice Location Address
First Line	:	8125 STENTON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19150-3530
Country	:	US
Telephone Number	:	215-248-7560
Fax Number	:	215-248-7564

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. SUSAN DENISE STUKES
Credential	:
Telephone Number	:	215-844-1020

Provider Enumeration Date	:	09/30/2009
Last Update Date	:	12/20/2023

Similar Medicare Providers

1275532160 — JOAN MUREEN ADDLEY DO
Practice Location Address:

8125 STENTON AVE
PHILADELPHIA, PA
19150-3530

Practice Phone: 215-248-7560
Practice Fax: 215-248-7564

1861538373 — DR. PARVANEH RAVANDOOST M.D.
Practice Location Address:

8125 STENTON AVE
PHILADELPHIA, PA
19150-3530

Practice Phone: 215-248-7560
Practice Fax: 215-248-7564

1770709164 — G. WINSTON STUBBS M.D., LTD
Practice Location Address:

8121 STENTON AVE # B
PHILADELPHIA, PA
19150-3530

Practice Phone: 215-248-2660
Practice Fax: 215-248-5336

1801065842 — MRS. JEANNIE M PEAKE BSN, MSN, CRNP
Practice Location Address:

8125 STENTON AVE
PHILADELPHIA, PA
19150-3530

Practice Phone: 215-248-7560
Practice Fax: 215-248-7564

1699190561 — COVENANT HOUSE INC
Practice Location Address:

8127 STENTON AVE
PHILADELPHIA, PA
19150-3530

Practice Phone: 267-331-9832
Practice Fax: 267-331-9932

1053992297 — DR. STEPHANIE ELIZABETH PATTERSON DMD
Practice Location Address:

8127 STENTON AVE
PHILADELPHIA, PA
19150-3530

Practice Phone: 215-844-1020
Practice Fax:

Directions to “COVENANT HOUSE, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.