Active NPI
North Haven Residential Care LLC
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Portage, MI
National Provider Identifier
1679413603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Legal business name
- NORTH HAVEN RESIDENTIAL CARE LLC
- Practice address
- 313 W Kilgore Rd
Portage, MI 49002-0501 - Phone
- (269) 220-1114
- NPI assigned
- Mar 30, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tety Mumararungu
- Title
- Ceo
- Phone
- (269) 220-1114
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Primary |
Addresses
Primary practice location
313 W Kilgore Rd
Portage, MI 49002-0501
Mailing address
313 W Kilgore Rd
Portage, MI 49002-0501
Phone (269) 220-1114
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774828800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1774828800000",
"number": "1679413603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 W KILGORE RD",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490020501",
"telephone_number": "269-220-1114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 W KILGORE RD",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490020501",
"telephone_number": "269-220-1114"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH HAVEN RESIDENTIAL CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-03-30",
"last_updated": "2026-03-30",
"certification_date": "2026-03-30",
"status": "A",
"authorized_official_last_name": "MUMARARUNGU",
"authorized_official_first_name": "TETY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "269-220-1114"
},
"taxonomies": [
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portage, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.