Organization
CENTRIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL JAY NAVES MASTER IN PA (TECHNICIAN)
(616) 308-7151
Entity
Organization
Contact information
Practice address
5963 JOHN DALY ST, TAYLOR, MI 48180-1055
(616) 308-7151
Mailing address
5963 JOHN DALY ST, TAYLOR, MI 48180-1055
(616) 308-7151
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
MI
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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