NATIONAL MENTOR HEALTHCARE, LLC (NPI# 1053621169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053621169 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE, LLC |
| Other Organization Name | INDIANA MENTOR ADULT FOSTER CARE |
| Practice Address |
5565 Van Buren St Merrillville IN 46410-2055 |
| Mailing Address |
8925 N Meridian St Ste 200 Indianapolis IN 46260-2386 |
| Practice Telephone | 3175812380 |
| Mailing Telephone | 3175812380 |
| Mailing Fax Number | 3175812378 |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2010-10-08 |
| Authorized Official Name | DAN MOHNKE (STATE DIRECTOR) |
| Authorized Official Telephone | 3175812380 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | PROVIDER NUMBER | 200943350D | 01 |
| Other Name | Type Code |
|---|---|
| Indiana Mentor Adult Foster Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730644725 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 4 Dogwood Ct, Hackettstown, NJ 07840-4800 | 2019-02-05 |
| 1568927556 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 143 Meadows Rd, Lafayette, NJ 07848-3120 | 2019-02-05 |
| 1548725534 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 23 Waterloo Rd, Stanhope, NJ 07874-3449 | 2019-02-05 |
| 1891250882 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 4 Tall Oaks Rd, Somerset, NJ 08873-3033 | 2019-02-05 |
| 1154886141 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 15 Rockleigh Dr, Ewing, NJ 08628-1516 | 2019-02-05 |
| 1366907354 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 23 Pritchard Ln, Sicklerville, NJ 08081-2013 | 2019-02-05 |
| 1114482007 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 270 Smithburg Rd, Manalapan, NJ 07726-8122 | 2019-02-05 |
| 1376008367 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 521 Townsbury Rd, Great Meadows, NJ 07838-2043 | 2019-02-05 |
| 1225593213 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 266 Jackson Mills Rd, Freehold, NJ 07728-8057 | 2019-02-05 |
| 1790235539 | National Mentor Healthcare, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 8 Dugans Grv, Millstone Twp, NJ 08535-8014 | 2016-10-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | NATIONAL MENTOR HEALTHCARE, LLC | 313 Congress St., Boston, MA 02210 |
| Indiana Business Entities | NATIONAL MENTOR HEALTHCARE, LLC | 313 Congress St, 5th Floor, Boston, MA 02210 |
| Street Address |
5565 VAN BUREN ST |
| City | MERRILLVILLE |
| State | IN |
| Zip Code | 46410-2055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023636867 | Lena Danielle Clouse | Pharmacist | Genoa Healthcare LLC, 8555 Taft Street, Merrillville, IN 46410 | 2020-07-08 |
| 1134752728 | All In One Therapy, LLC | Speech-Language Pathologist | 1800 W 84th Drive, Merrillville, IN 46410 | 2020-02-21 |
| 1134759335 | David John Kujawa | Social Worker | 8398 Mississippi St., Merrillville, IN 46410 | 2020-01-16 |
| 1619513603 | Activate Healthcare - Plumbers Local 210 Clinic | Clinic/Center | 2905 E 83rd Place, Merrillville, IN 46410 | 2019-11-25 |
| 1568946994 | Larry Smith | Case Manager/Care Coordinator | 233 E 83, Merrillville, IN 46410 | 2018-09-21 |
| 1114401536 | The Sheet People | Durable Medical Equipment & Medical Supplies | 8874 Louisiana Street, Merrillville, IN 46410 | 2018-09-21 |
| 1659858439 | Heather Grinder | Hearing Instrument Specialist | 9120 Connecticut Dr., Suite C, Merrillville, IN 46410 | 2018-07-24 |
| 1710463872 | Mitchell G Smith | Optometrist | 1601 E 81st Ave, Merrillville, IN 46410 | 2018-07-12 |
| 1336631753 | Nwi Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 1454 E. 86th Place, Merrillville, IN 46410 | 2018-06-01 |
| 1659860427 | Wendell B Fleming | Counselor | 230 West 175th Place, Apartment I, Merrillville, IN 46410 | 2018-05-07 |
| Find all providers in zip 46410 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417173345 | Arc Bridges, Inc | Custodial Care Facility | 407 W 75th Pl, Merrillville, IN 46410-4601 | 2007-04-18 |
| 1851517783 | Arc Bridges, Inc | Custodial Care Facility | 6101 Hayes St, Merrillville, IN 46410-2358 | 2007-04-18 |
| 1508082439 | Arc Bridges, Inc | Custodial Care Facility | 336 W 56th Ave, Merrillville, IN 46410-2025 | 2007-04-18 |
| 1265658199 | Arc Bridges, Inc | Custodial Care Facility | 1921 W 54th Ave, Merrillville, IN 46410-1331 | 2007-04-18 |
| 1912123845 | Arc Bridges, Inc | Custodial Care Facility | 6371 Vermont St, Merrillville, IN 46410-2747 | 2007-04-18 |
| 1639395577 | Arc Bridges, Inc | Custodial Care Facility | 2414 Woodlane Dr, Merrillville, IN 46410-2861 | 2007-04-18 |
| 1942426879 | Arc Bridges, Inc | Custodial Care Facility | 6643 Fillmore St, Merrillville, IN 46410-3224 | 2007-04-18 |
| 1215153143 | Arc Bridges, Inc | Custodial Care Facility | 5777 Ellsworth Ct, Merrillville, IN 46410-2162 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093315095 | Shana P Graham | Custodial Care Facility | 8308 E 11th St, Indianapolis, IN 46219-4003 | 2020-10-28 |
| 1730650169 | Benson Ngarambe | Custodial Care Facility | 719 Roland Ct, South Bend, IN 46601-3461 | 2018-12-11 |
| 1629513700 | Violet Johnson | Custodial Care Facility | 3213 N Riley Ave, Indianapolis, IN 46218-2350 | 2016-12-28 |
| 1477931764 | Grace Adult Family Care LLC | Custodial Care Facility | 2947 N Colorado Ave, Indianapolis, IN 46218-3116 | 2015-05-07 |
| 1164852505 | R&l Supportive Living Corp. | Custodial Care Facility | 3754 Jackson St, Gary, IN 46408-2226 | 2013-11-21 |
| 1932546959 | National Mentor Healtcare LLC | Custodial Care Facility | 6323 Tennessee Ave, Hammond, IN 46323-1934 | 2013-05-31 |
| 1598005423 | National Mentor Healthcare LLC | Custodial Care Facility | 6032 W 7th Ave, Gary, IN 46406-1314 | 2013-03-01 |
| 1497095327 | National Mentor Healthcare, LLC | Custodial Care Facility | 57155 White Pine Trl, South Bend, IN 46619-5584 | 2013-03-01 |
| 1821358342 | National Mentor Healthcare, LLC | Custodial Care Facility | 1726 N 100 W, Hartford City, IN 47348-9550 | 2012-05-17 |
| 1669732186 | National Mentor Healthcare, LLC | Custodial Care Facility | 2326 Flint Ct, Dyer, IN 46311-1913 | 2012-05-17 |
| Find all providers with the same taxonomy | ||||
| City | MERRILLVILLE |
| Zip Code | 46410 |
Please comment or provide details below to improve the information on NATIONAL MENTOR HEALTHCARE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.