Provider Demographics
NPI:1396933388
Name:ROMARIE RESIDENTIAL SERVICES
Entity type:Organization
Organization Name:ROMARIE RESIDENTIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:EZE
Authorized Official - Last Name:OFFIONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-423-3093
Mailing Address - Street 1:16250 NORTHLAND DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5205
Mailing Address - Country:US
Mailing Address - Phone:248-423-3093
Mailing Address - Fax:248-200-0093
Practice Address - Street 1:16250 NORTHLAND DR
Practice Address - Street 2:SUITE 115
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5205
Practice Address - Country:US
Practice Address - Phone:248-423-3093
Practice Address - Fax:248-200-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS820286212311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home