Provider Demographics
NPI:1770911703
Name:ROMANCARE HEALTH SERVICES
Entity type:Organization
Organization Name:ROMANCARE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:313-575-4178
Mailing Address - Street 1:9600 DEXTER AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48206-1816
Mailing Address - Country:US
Mailing Address - Phone:248-218-1198
Mailing Address - Fax:248-218-1888
Practice Address - Street 1:9600 DEXTER AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48206-1816
Practice Address - Country:US
Practice Address - Phone:248-218-1199
Practice Address - Fax:248-218-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-30
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty