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Organization

NORTH HAVEN RESIDENTIAL CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TETY MUMARARUNGU (CEO)
(269) 220-1114
Entity
Organization

Contact information

Practice address
313 W KILGORE RD, PORTAGE, MI 49002-0501
(269) 220-1114
Mailing address
313 W KILGORE RD, PORTAGE, MI 49002-0501
(269) 220-1114

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
03/30/2026
Last updated
03/30/2026
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