NPIMap

Organization Active NPI

National Mentor Healthcare, LLC

Doing business as North Carolina Mentor

  • Public Health or Welfare Agency
  • Jacksonville, NC
National Provider Identifier
1174840292
Registry record updated Mar 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
NATIONAL MENTOR HEALTHCARE, LLC
Doing business as
North Carolina Mentor
Practice address
10 Dewitt St
Jacksonville, NC 28540-5649
Phone
(910) 219-3120
Fax
(910) 219-3241
NPI assigned
Apr 29, 2010
Last updated
Mar 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

10 Dewitt St
Jacksonville, NC 28540-5649

Mailing address

313 Congress St
Boston, MA 02210-1218
Phone (800) 388-5150

Other names 1

  • North Carolina 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 22

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

View all 22

Locations

10 Dewitt St
Jacksonville, NC 28540
Phone (334) 805-6144

NPI Registry JSON

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677974400000",
    "number": "1174840292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 CONGRESS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022101218",
            "telephone_number": "800-388-5150",
            "fax_number": "617-790-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DEWITT ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405649",
            "telephone_number": "910-219-3120",
            "fax_number": "910-219-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL MENTOR HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-29",
        "last_updated": "2023-03-05",
        "certification_date": "2023-03-05",
        "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": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Carolina Mentor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Carolina Mentor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.