Active NPI
National Mentor Healthcare, LLC
- Community/Behavioral Health Agency
- Smithfield, RI
National Provider Identifier
1073637807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 45813
- Legal business name
- NATIONAL MENTOR HEALTHCARE, LLC
- Practice address
- 25 Thurber Blvd
Smithfield, RI 02917 - Phone
- (401) 231-0739
- Fax
- (401) 232-0651
- NPI assigned
- Mar 19, 2007
- Organization subpart
- Yes
- Parent organization
- NATIONAL MENTOR HEALTHCARE LLC DBA RHODE ISLAND MENTOR
NPPES NPI Registry
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | 323 | RI | |
| Community/Behavioral Health Agency | 251S00000X | 45813 | RI | Primary |
Addresses
Primary practice location
25 Thurber Blvd
Smithfield, RI 02917
Mailing address
625 W Ridge Pike
BLDG B Suite 102
Conshohocken, PA 19428
Phone (610) 834-2971
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MC11015 | Other | RI | PROVIDER NUMBER |
Other names 1
- Rhode Island Mentor
National Provider Directory
National Provider Directory- Tax ID family
- California Mentor
- Part of
- California Mentor
Locations
25 Thurber Blvd
Smithfield, RI 02917
Phone (401) 231-0739
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1677888000000",
"number": "1073637807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 W RIDGE PIKE",
"address_2": "BLDG B SUITE 102",
"city": "CONSHOHOCKEN",
"state": "PA",
"postal_code": "19428",
"telephone_number": "610-834-2971",
"fax_number": "610-825-2831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 THURBER BLVD",
"city": "SMITHFIELD",
"state": "RI",
"postal_code": "02917",
"telephone_number": "401-231-0739",
"fax_number": "401-232-0651"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NATIONAL MENTOR HEALTHCARE, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "NATIONAL MENTOR HEALTHCARE LLC DBA RHODE ISLAND MENTOR",
"enumeration_date": "2007-03-19",
"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": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": "RI",
"license": "323",
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "RI",
"license": "45813",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER NUMBER",
"identifier": "MC11015",
"state": "RI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Rhode Island Mentor",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Rhode Island Mentor",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Smithfield, RI
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.