Active NPI
Raduan Sultan Raju
- Adult Care Home Facility
- Warren, MI
National Provider Identifier
1346000841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- Practice address
- 29658 Van Laan Dr
Warren, MI 48092-4251 - Phone
- (586) 565-4766
- NPI assigned
- Mar 21, 2024
- Last updated
- Mar 21, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | NU | Primary |
Addresses
Primary practice location
29658 Van Laan Dr
Warren, MI 48092-4251
Mailing address
29658 Van Laan Dr
Warren, MI 48092-4251
Phone (586) 565-4766
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sultan Home Care LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710979200000",
"number": "1346000841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29658 VAN LAAN DR",
"city": "WARREN",
"state": "MI",
"postal_code": "480924251",
"telephone_number": "586-565-4766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29658 VAN LAAN DR",
"city": "WARREN",
"state": "MI",
"postal_code": "480924251",
"telephone_number": "586-565-4766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJU",
"first_name": "RADUAN",
"middle_name": "SULTAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-03-21",
"last_updated": "2024-03-21",
"certification_date": "2024-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.