Radakovic Kids Co Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

23-E281 Issued in MI

Legal business name

RADAKOVIC KIDS CO INC

Practice address

520 W Main Street
Northville, MI 48167-0206

Phone

(248) 349-4290

Fax

(248) 349-1663

NPI assigned

Jul 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Diana Marie Gabriel, NHA

Title

Director-Ceo

Phone

(248) 349-4290

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Star Manor of Northville Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447283239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 W MAIN STREET",
            "address_2": "PO BOX 206",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481670206",
            "telephone_number": "248-349-4290",
            "fax_number": "248-349-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W MAIN STREET",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481670206",
            "telephone_number": "248-349-4290",
            "fax_number": "248-349-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADAKOVIC KIDS CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR-CEO",
        "authorized_official_telephone_number": "248-349-4290",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MI",
            "license": "23-E281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23-E281",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Star Manor of Northville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Kozlowski Ptak, M.A. LPC
• Megan Michell Pummell, LAT, ATC
• Mandra Quassis
• Quest Diagnostics Incorporated
• R3A Corp
• Radiology Reads PLLC
• Ateeq Rahman, DPT
• Skylar Raitt
• Achyutha Valli Rallapalli, DDS
• Randall a. Bickle, DO., PC

• Nursing Facility/Intermediate Care Facility in Northville, MI
• Providers in Northville, MI by specialty
• Nursing Facility/Intermediate Care Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.