NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
1720134943 |   |   |   | COVENANT COMMUNITY CARE, INC. | 559 W GRAND BLVD | DETROIT | MI | 482162200 |
1932492485 | PETTWAY | GWENDOLYN |   |   | 559 W GRAND BLVD | DETROIT | MI | 482162200 |