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General NPI Number Information
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NPI Number | 1174716914
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Entity Type | Organization
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Legal Business Name | SAGINAW VALLEY CENTERS, INC
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 08/24/2007
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Provider Practice Location Address
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Address Line | 510 S WASHINGTON ST
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City | OWOSSO
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State | MI
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Zip | 48867-3545
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Country | US
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Telephone | 989-790-3366
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Fax |
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Provider Business Mailing Address
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Address Line | 3190 HALLMARK CT
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City | SAGINAW
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State | MI
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Zip | 48603-2190
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Country | US
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Telephone | 989-790-3366
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | DIONNE HOLLENBACK
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Credential |
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Telephone | 989-790-3366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 780038
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License Number State | MI
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