NPIMap

Organization Active NPI

NJ Mentor

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Somerset, NJ
National Provider Identifier
1053570135
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
NJ MENTOR
Practice address
80 Cottontail LN
Suite 330
Somerset, NJ 08873-1100
Phone
(732) 627-9890
Fax
(732) 627-8412
NPI assigned
Jun 4, 2008
Last updated
Mar 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2023

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

Authorized official

Name
Brett Ian Cohen
Title
Coo
Phone
(800) 388-5150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NU Primary

Addresses

Primary practice location

80 Cottontail LN
Suite 330
Somerset, NJ 08873-1100

Mailing address

80 Cottontail LN
Suite 330
Somerset, NJ 08873-1100
Phone (732) 627-9890

Other identifiers 1

IdentifierTypeStateIssuer
5585805MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
California Mentor336 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677888000000",
    "number": "1053570135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 COTTONTAIL LN",
            "address_2": "SUITE 330",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731100",
            "telephone_number": "732-627-9890",
            "fax_number": "732-627-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 COTTONTAIL LN",
            "address_2": "SUITE 330",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731100",
            "telephone_number": "732-627-9890",
            "fax_number": "732-627-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ MENTOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-04",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "800-388-5150"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5585805",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.