NPIMap

Organization Active NPI

Massachusetts Mentor LLC

  • Home Health Agency
  • Brockton, MA
National Provider Identifier
1093481848
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MASSACHUSETTS MENTOR LLC
Practice address
1115 W Chestnut St Ste 202
Brockton, MA 02301-7501
Phone
(508) 824-1355
Fax
(508) 824-3732
NPI assigned
Aug 20, 2021
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
Ryan James Lovelady
Title
State Director
Phone
(862) 284-4565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1115 W Chestnut St Ste 202
Brockton, MA 02301-7501

Mailing address

1115 W Chestnut St Ste 202
Brockton, MA 02301-7501
Phone (508) 824-1355

National Provider Directory

National Provider Directory
Tax ID family
Massachusetts Mentor LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

350 Myles Standish Blvd
Ste 202
Taunton, MA 02780

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1093481848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 W CHESTNUT ST STE 202",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017501",
            "telephone_number": "508-824-1355",
            "fax_number": "508-824-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 W CHESTNUT ST STE 202",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017501",
            "telephone_number": "508-824-1355",
            "fax_number": "508-824-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSACHUSETTS MENTOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-20",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "LOVELADY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "STATE DIRECTOR",
        "authorized_official_telephone_number": "862-284-4565"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

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.