NPIMap

Organization Active NPI

National Mentor Healthcare, LLC

Doing business as Arizona Mentor- Evergreen

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1003049487
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH-3412 Issued in AZ
Legal business name
NATIONAL MENTOR HEALTHCARE, LLC
Doing business as
Arizona Mentor- Evergreen
Practice address
3838 N Central Ave Ste 1200
Phoenix, AZ 85012-1997
Phone
(480) 646-6175
Fax
(602) 567-2062
NPI assigned
Sep 1, 2009
Last updated
Aug 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Authorized official

Name
Mary Patricia Rodenberg-Roberts
Title
VP & Sr Asst General Counsel
Phone
(952) 836-2234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH-3412 AZ Primary

Addresses

Primary practice location

3838 N Central Ave Ste 1200
Phoenix, AZ 85012-1997

Mailing address

3838 N Central Ave Ste 1200
Phoenix, AZ 85012-1997
Phone (480) 646-6175

Other practice location 1

9225 W Elm St
Phoenix, AZ 85037-1003
Phone (623) 877-0213

Other names 1

  • Arizona Mentor- Evergreen Doing business as

National Provider Directory

National Provider Directory
Tax ID family
National Mentor Healthcare336 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1003049487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 N CENTRAL AVE STE 1200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121997",
            "telephone_number": "480-646-6175",
            "fax_number": "602-567-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N CENTRAL AVE STE 1200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121997",
            "telephone_number": "480-646-6175",
            "fax_number": "602-567-2062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9225 W Elm St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850371003",
            "country_code": "US",
            "telephone_number": "623-877-0213",
            "fax_number": "623-877-0239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NATIONAL MENTOR HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-01",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "RODENBERG-ROBERTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "VP & SR ASST GENERAL COUNSEL",
        "authorized_official_telephone_number": "952-836-2234"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH-3412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona Mentor- Evergreen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.