NPIMap

Organization Active NPI

National Mentor Healthcare Network

Doing business as New Jersey MENTOR

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Atco, NJ
National Provider Identifier
1104335298
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
NATIONAL MENTOR HEALTHCARE NETWORK
Doing business as
New Jersey MENTOR
Practice address
2301 Atco Ave
Atco, NJ 08004-1714
Phone
(732) 627-9890
NPI assigned
Sep 21, 2017
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU Primary

Addresses

Primary practice location

2301 Atco Ave
Atco, NJ 08004-1714

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0415260MedicaidNJ

Other names 1

  • New Jersey MENTOR Doing business as

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 23

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

View all 23

Locations

2301 Atco Ave
Atco, NJ 08004

NPI Registry JSON

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677888000000",
    "number": "1104335298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 COTTONTAIL LN STE 330",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731100",
            "telephone_number": "732-627-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ATCO AVE",
            "city": "ATCO",
            "state": "NJ",
            "postal_code": "080041714",
            "telephone_number": "732-627-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL MENTOR HEALTHCARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-21",
        "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": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0415260",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Jersey MENTOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atco, 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.