National Mentor Healthcare, LLC
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · New Whiteland, IN
NPI 1154570455 · NPPES record last updated Mar 4, 2023
Key facts
- NPI
- 1154570455
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Legal business name
- NATIONAL MENTOR HEALTHCARE, LLC
- Practice address
- 518 Mooreland Dr
New Whiteland, IN 46184-1222 - Phone
- (317) 581-2380
- Fax
- (317) 581-2378
- NPI assigned
- Sep 11, 2008
- Organization subpart
- No
Authorized official
- Name
- Brett Ian Cohen
- Title
- Coo
- Phone
- (800) 388-5150
Corporate family (same tax ID) 20
National Provider Directory
- Tax ID family
- California Mentor
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes |
Addresses
Primary practice location
518 Mooreland Dr
New Whiteland, IN 46184-1222
Mailing address
313 Congress St
Boston, MA 02210-1218
Phone (800) 388-5150
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200193830 C | Other | IN | PROVIDER NUMBER |
Other names
- Indiana Mentor Adult Foster Care
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.