Provider Demographics
NPI:1528143831
Name:ROMEO NURSING CENTER INC
Entity type:Organization
Organization Name:ROMEO NURSING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOCKE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER ADMINISTRATOR
Authorized Official - Phone:586-752-3571
Mailing Address - Street 1:250 DENBY ST
Mailing Address - Street 2:
Mailing Address - City:ROMEO
Mailing Address - State:MI
Mailing Address - Zip Code:48065-5228
Mailing Address - Country:US
Mailing Address - Phone:586-752-3571
Mailing Address - Fax:586-336-9066
Practice Address - Street 1:250 DENBY ST
Practice Address - Street 2:
Practice Address - City:ROMEO
Practice Address - State:MI
Practice Address - Zip Code:48065-5228
Practice Address - Country:US
Practice Address - Phone:586-752-3571
Practice Address - Fax:586-336-9066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI504150313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2081661Medicaid