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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