NPIMap

Organization Active NPI

National Mentor Healthcare LLC, D.B.a. PA Mentor

  • Community/Behavioral Health Agency
  • Conshohocken, PA
National Provider Identifier
1487060638
Registry record updated Mar 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
201400 Issued in PA
Legal business name
NATIONAL MENTOR HEALTHCARE LLC, D.B.A. PA MENTOR
Practice address
625 W Ridge Pike
BLDG B, Suite 102
Conshohocken, PA 19428-1180
Phone
(866) 271-1802
NPI assigned
Jul 9, 2014
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 201400 PA Primary

Addresses

Primary practice location

625 W Ridge Pike
BLDG B, Suite 102
Conshohocken, PA 19428-1180

Mailing address

625 W Ridge Pike
BLDG B, Suite 102
Conshohocken, PA 19428-1180

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678579200000",
    "number": "1487060638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W RIDGE PIKE",
            "address_2": "BLDG B, SUITE 102",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194281180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W RIDGE PIKE",
            "address_2": "BLDG B, SUITE 102",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194281180",
            "telephone_number": "866-271-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL MENTOR HEALTHCARE LLC, D.B.A. PA MENTOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-09",
        "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": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "201400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conshohocken, PA

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.