| Jomie Goerge, Llc | |
|
1818 W Centre Ave Portage MI 49024-5332 | |
| (269) 377-4850 | |
| Not Available |
| Full Name | Jomie Goerge, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1818 W Centre Ave, Portage, Michigan |
| Authorized Official Name and Position | Jomarie Goerge (OWNER) |
| Authorized Official Contact | 2694926473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jomie Goerge, Llc 9523 W Rs Ave Schoolcraft MI 49087-8428 Ph: (269) 492-6471 | Jomie Goerge, Llc 1818 W Centre Ave Portage MI 49024-5332 Ph: (269) 377-4850 |
| NPI Number | 1063153484 |
|---|---|
| Provider Enumeration Date | 04/07/2022 |
| Last Update Date | 02/06/2025 |
| Certification Date | 02/06/2025 |
| Medicare PECOS PAC ID | 4981091980 |
|---|---|
| Medicare Enrollment ID | O20220421000919 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063153484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jomarie Goerge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457657884 PECOS PAC ID: 6709273709 Enrollment ID: I20220421000988 |
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