NPIMap

Organization Active NPI

National Mentor Services, LLC

  • Behavior Analyst
  • Saint Louis, MO
National Provider Identifier
1235775248
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
NATIONAL MENTOR SERVICES, LLC
Practice address
11872 Westline Industrial Dr Ste 180
Saint Louis, MO 63146-3331
Phone
(314) 991-7944
NPI assigned
Nov 25, 2019
Organization subpart
Yes
Parent organization
NATIONAL MENTOR SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Morgan KeenceNPI 1114317500
Title
Bcba
Phone
(314) 991-7944

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Assistant Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 106E00000X
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X

Addresses

Primary practice location

11872 Westline Industrial Dr Ste 180
Saint Louis, MO 63146-3331

Mailing address

6067 Mexico Rd
Saint Peters, MO 63376-1648
Phone (636) 685-0804

Other practice location 1

6067 Mexico Rd
Saint Peters, MO 63376-1648
Phone (636) 685-0804

Other names 1

  • Missouri Mentor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
National Mentor Services LLC4 organizations share this tax ID, including this one
Part of
National Mentor Services LLC

Other organizations with this tax ID 3

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

Locations

11872 Westline Industrial Dr
Ste 180
Saint Louis, MO 63146
Phone (309) 322-8391

6067 Mexico Rd
Saint Peters, MO 63376
Phone (636) 685-0804

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574640000000",
    "number": "1235775248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6067 MEXICO RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761648",
            "telephone_number": "636-685-0804",
            "fax_number": "636-685-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11872 WESTLINE INDUSTRIAL DR STE 180",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463331",
            "telephone_number": "314-991-7944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6067 Mexico Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633761648",
            "country_code": "US",
            "telephone_number": "636-685-0804",
            "fax_number": "636-685-0805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NATIONAL MENTOR SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATIONAL MENTOR SERVICES, LLC",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A",
        "authorized_official_last_name": "KEENCE",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "BCBA",
        "authorized_official_telephone_number": "314-991-7944"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Missouri Mentor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.