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Organization
RADAKOVIC KIDS CO INC
Active
Organization
RADAKOVIC KIDS CO INC
Active
Other names
Star Manor of Northville
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA MARIE GABRIEL NHA (DIRECTOR-CEO)
(248) 349-4290
Entity
Organization
Contact information
Practice address
520 W MAIN STREET, NORTHVILLE, MI 48167-0206
(248) 349-4290
(248) 349-1663
Mailing address
520 W MAIN STREET, PO BOX 206, NORTHVILLE, MI 48167-0206
(248) 349-4290
(248) 349-1663
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
23-E281
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23-E281
—
MI
Enumeration date
07/08/2006
Last updated
08/22/2020
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