Organization
PATIENT SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD ANGELO DICICCO (PRESIDENT)
(586) 751-2903
Entity
Organization
Contact information
Practice address
28120 DEQUINDRE RD, WARREN, MI 48092-5603
(586) 751-2903
Mailing address
28120 DEQUINDRE RD, WARREN, MI 48092-5603
(586) 751-2903
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/23/2010
Last updated
07/23/2010
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