NPIMap

Organization Active NPI

National Mentor Healthcare, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Somerset, NJ
National Provider Identifier
1376921296
Registry record updated Mar 12, 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
Practice address
80 Cottontail LN
Ste 330
Somerset, NJ 08873-1100
Phone
(732) 627-9890
Fax
(732) 563-6780
NPI assigned
May 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Community/Behavioral Health Agency 251S00000X
In Home Supportive Care Agency 253Z00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

80 Cottontail LN
Ste 330
Somerset, NJ 08873-1100

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0493163MedicaidNJ

Other names 1

  • NJ 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": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678579200000",
    "number": "1376921296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 COTTONTAIL LN",
            "address_2": "STE 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": "80 COTTONTAIL LN",
            "address_2": "STE 330",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731100",
            "telephone_number": "732-627-9890",
            "fax_number": "732-563-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL MENTOR HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2023-03-12",
        "certification_date": "2023-03-12",
        "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": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0493163",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NJ Mentor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NJ Mentor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.