NPIMap

National Mentor Healthcare, LLC

Organization Active NPI Adult Care Home Facility · South Bend, IN

NPI 1194034827 · NPPES record last updated Mar 5, 2023

Key facts

NPI
1194034827
Entity type
Organization (NPI type 2)
Primary specialty
Adult Care Home Facility 311ZA0620X
Legal business name
NATIONAL MENTOR HEALTHCARE, LLC
Practice address
719 Haney Ave
South Bend, IN 46613-2609
Phone
(317) 581-2380
NPI assigned
Sep 29, 2010
Organization subpart
No

Authorized official

Name
Brett Ian Cohen
Title
Coo
Phone
(800) 388-5150

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
California Mentor (336 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Yes

Addresses

Primary practice location

719 Haney Ave
South Bend, IN 46613-2609

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
200943350AOtherINPROVIDER NUMBER

Other names

  • Indiana MENTOR Adult Foster Care Doing business as

Other providers in South Bend, IN

All providers in South Bend, IN · Adult Care Home Facility in Indiana

Sources for this page

Verify at the official NPI Registry.