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Organization

PATIENT SUPPORT SERVICES

Active
Parent organization
SPECTRUN HEALTH CARE
Organization subpart
Yes

Provider details

NPI number
Legal business name
SPECTRUN HEALTH CARE
Authorized official
MR. RONALD DICICCO (CEO)
(248) 591-9500
Entity
Organization

Contact information

Practice address
28050 JOHN R RD, MADISON HTS, MI 48071-2812
(248) 591-9500
Mailing address
28050 JOHN R RD, MADISON HTS, MI 48071-2812
(248) 591-9500

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary

Other

Enumeration date
07/24/2007
Last updated
07/24/2007
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