NPIMap

Organization Active NPI

National Mentor Healthcare, LLC

Doing business as New Jersey MENTOR

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Willingboro, NJ
National Provider Identifier
1205216231
Registry record updated Mar 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
NATIONAL MENTOR HEALTHCARE, LLC
Doing business as
New Jersey MENTOR
Practice address
66 Rittenhouse Dr
Willingboro, NJ 08046-2544
Phone
(732) 627-9890
NPI assigned
Jun 4, 2015
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
(617) 790-4271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

66 Rittenhouse Dr
Willingboro, NJ 08046-2544

Mailing address

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

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677974400000",
    "number": "1205216231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 COTTONTAIL LN",
            "address_2": "SUITE 330",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731100",
            "telephone_number": "732-627-9890",
            "fax_number": "732-563-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 RITTENHOUSE DR",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080462544",
            "telephone_number": "732-627-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL MENTOR HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "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": "617-790-4271"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Jersey MENTOR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New Jersey MENTOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willingboro, NJ

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.