# RADAKOVIC KIDS CO INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Star Manor of Northville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447283239
- **Authorized official:** MRS. DIANA MARIE GABRIEL NHA (DIRECTOR-CEO)
- **Authorized official phone:** (248) 349-4290

## Contact information

- **Practice address:** 520 W MAIN STREET, NORTHVILLE, MI 48167-0206
- **Practice address phone:** (248) 349-4290
- **Practice address fax:** (248) 349-1663
- **Mailing address:** 520 W MAIN STREET, PO BOX 206, NORTHVILLE, MI 48167-0206
- **Mailing address phone:** (248) 349-4290
- **Mailing address fax:** (248) 349-1663

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 23-E281 | MI | Yes |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 23-E281 | — | MI |