NPIMap

Organization Active NPI

Mentor Healthcare, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1154488112
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
2740 Issued in AZ
Legal business name
MENTOR HEALTHCARE, INC
Practice address
9131 W Cambridge Ave
Phoenix, AZ 85037-4255
Phone
(623) 643-9402
Fax
(602) 567-2062
NPI assigned
Jan 2, 2007
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 2740 AZ Primary

Addresses

Primary practice location

9131 W Cambridge Ave
Phoenix, AZ 85037-4255

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
84431MedicaidAZ

Other names 1

  • Arizona 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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1154488112",
    "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": "617-790-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9131 W CAMBRIDGE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374255",
            "telephone_number": "623-643-9402",
            "fax_number": "602-567-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTOR HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "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": "2740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84431",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona Mentor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arizona Mentor",
            "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.