NPIMap

Organization Active NPI

National Mentor Healthcare, LLC

  • Adult Care Home Facility
  • Dyer, IN
National Provider Identifier
1669732186
Registry record updated Mar 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
NATIONAL MENTOR HEALTHCARE, LLC
Practice address
2326 Flint CT
Dyer, IN 46311-1913
Phone
(317) 581-2380
NPI assigned
May 17, 2012
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
Adult Care Home Facility 311ZA0620X Primary

Addresses

Primary practice location

2326 Flint CT
Dyer, IN 46311-1913

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
200943350MedicaidIN

Other names 1

  • Indiana Mentor Adult Foster Care 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": "1337212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678579200000",
    "number": "1669732186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 CONGRESS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022101218",
            "telephone_number": "800-388-5150",
            "fax_number": "617-790-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2326 FLINT CT",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111913",
            "telephone_number": "317-581-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL MENTOR HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-17",
        "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": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200943350",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indiana Mentor Adult Foster Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Indiana Mentor Adult Foster Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dyer, IN

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.