Goretti Health LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

GORETTI HEALTH LLC

Practice address

4303 Linden Dr
Midland, MI 48640-2615

Phone

(989) 400-5367

NPI assigned

Oct 27, 2021

Last updated

Sep 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Fidelis KamuntuNPI 1114327178

Title

Manager

Phone

(701) 429-8305

Specialties & licenses 1

Addresses

Other names 1

• Goretti Adult Foster Care Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fidelis Kamuntu

  • Pharmacist
  • Farwell, MI
  • NPI 1114327178
  NPD Authorized official

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1467116236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4303 LINDEN DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402615",
            "telephone_number": "989-400-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 LINDEN DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402615",
            "telephone_number": "989-400-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORETTI HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-27",
        "last_updated": "2023-09-06",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "KAMUNTU",
        "authorized_official_first_name": "FIDELIS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "701-429-8305"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goretti Adult Foster Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• E'Liyah Gonzalez
• Michelle Gonzalez
• Dylan Goodrich
• Michelle Goodwin
• Andrew Gordon, LPC
• Colleen Gorman, MSW
• Tiphani Lenae Goul
• Lucas Gourd
• Pamela Lane Graber, LLBSW
• Rebecca L Grabowski

• Custodial Care Facility in Midland, MI
• Providers in Midland, MI by specialty
• Custodial Care Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.