NPIMap

Organization Active NPI

National Mentor Healthcare, LLC

Doing business as Pennsylvania Mentor

  • Community/Behavioral Health Agency
  • Broomall, PA
National Provider Identifier
1952989212
Registry record updated Mar 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NATIONAL MENTOR HEALTHCARE, LLC
Doing business as
Pennsylvania Mentor
Practice address
450 Parkway Ste 200
Broomall, PA 19008-4202
Phone
(484) 868-5813
NPI assigned
Mar 30, 2021
Last updated
Mar 19, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
NATIONAL MENTOR HEALTHCARE LLC, D.B.A. PENNSYLVANIA MENTORAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 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 Primary

Addresses

Primary practice location

450 Parkway Ste 200
Broomall, PA 19008-4202

Mailing address

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

Other names 1

  • Pennsylvania Mentor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
National Mentor Healthcare336 organizations share this tax ID, including this one
Part of
National Mentor Healthcare

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.

Locations

450 Parkway
Ste 200
Broomall, PA 19008
Phone (484) 868-5813

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679184000000",
    "number": "1952989212",
    "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": "450 PARKWAY STE 200",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190084202",
            "telephone_number": "484-868-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL MENTOR HEALTHCARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATIONAL MENTOR HEALTHCARE LLC, D.B.A. PENNSYLVANIA MENTOR",
        "enumeration_date": "2021-03-30",
        "last_updated": "2023-03-19",
        "certification_date": "2023-03-19",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pennsylvania Mentor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pennsylvania Mentor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Broomall, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.