Organization
GERIATRIC PSYCHIATRIC SERVICES PLLC
Active
Parent organization
GERIATRIC PSYCHIATRIC SERVICES
Other names
Social Worker Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
GERIATRIC PSYCHIATRIC SERVICES
Authorized official
ROBERT A CLEMENTE (MANAGER)
(586) 620-8100
Entity
Organization
Contact information
Practice address
28800 RYAN RD, SUITE 320, WARREN, MI 48092-4269
(586) 620-8100
(866) 227-7418
Mailing address
28800 RYAN RD, SUITE 320, WARREN, MI 48092-4269
(586) 620-8100
(866) 227-7418
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800F340290
BCBS PIN NUMBER
MI
Enumeration date
01/12/2009
Last updated
10/14/2010
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