NATIONAL MENTOR HEALTHCARE, LLC (NPI# 1255647913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255647913 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE, LLC |
| Other Organization Name | INDIANA MENTOR ADULT FOSTER CARE |
| Practice Address |
244 E Butler St Fort Wayne IN 46803-3308 |
| Mailing Address |
8925 N Meridian St Suite 200 Indianapolis IN 46260-2386 |
| Practice Telephone | 3175812380 |
| Mailing Telephone | 3175812380 |
| Mailing Fax Number | 3175812378 |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2010-08-19 |
| Authorized Official Name | DANIEL MOHNKE (STATE DIRECTOR) |
| Authorized Official Telephone | 3175812380 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | PROVIDER NUMBER | 200193830M | 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 |
| Washington State Corporations | NATIONAL MENTOR HEALTHCARE, LLC | 313 Congress St, 5th Floor, Boston, MA 02210 |
| Street Address |
244 E BUTLER ST |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46803-3308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669811931 | Alyssa Kate Elaine Pierce | Registered Nurse | 3044 Schele Ave, Fort Wayne, IN 46803 | 2013-06-20 |
| 1538188164 | Deanna A Young | Counselor | 2020 East Washington Blvd, Suite 700, Fort Wayne, IN 46803 | 2006-07-18 |
| 1265491211 | Kamie Joy Lucas | Specialist/Technologist | 1600 E Washington Blvd, Indiana Institute of Technology, Fort Wayne, IN 46803 | 2006-03-20 |
| 1164693255 | Aaa Superior, Inc. | Taxi | 1520 E Berry St, Fort Wayne, IN 46803-1001 | 2008-03-17 |
| 1265951255 | Kailen Berry | Specialist/Technologist | 1600 E Washington Blvd, Fort Wayne, IN 46803-1228 | 2017-09-12 |
| 1013453927 | Nathaniel Acree | Specialist/Technologist | 1600 E Washington Blvd, Fort Wayne, IN 46803-1228 | 2017-01-17 |
| 1689784225 | Parkview Hospital | General Acute Care Hospital | 1600 E Washington Blvd, Fort Wayne, IN 46803-1228 | 2006-08-30 |
| 1093774796 | Mcgee-lytle Inc | Psychologist | 2020 E Washington Blvd, Suite 650, Fort Wayne, IN 46803-1327 | 2006-03-21 |
| 1770722878 | Jennifer L Malott | Social Worker | 2020 E Washington Blvd, Suite 700, Fort Wayne, IN 46803-1359 | 2009-02-12 |
| 1356583918 | Angela Robbins Gebert | Durable Medical Equipment & Medical Supplies | 5436 Old Maumee Rd, Unit 1, Fort Wayne, IN 46803-1713 | 2009-03-28 |
| Find all providers in zip 46803 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700248564 | A.i.d. Residential Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10319 Dawsons Creek Blvd Ste E, Fort Wayne, IN 46825-1911 | 2016-03-22 |
| 1386953024 | National Mentor Healthcare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6008 Brandy Chase Cv, Fort Wayne, IN 46815-7601 | 2010-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336749910 | Aspire Residential Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11216 Harrington Ln, Fishers, IN 46038-3208 | 2020-10-31 |
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1619528700 | A Totality of Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4302 Parrish Ave, East Chicago, IN 46312-3031 | 2019-09-20 |
| 1750851192 | Stimuli Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6670 Kinnerton Dr, Indianapolis, IN 46254-5843 | 2018-11-28 |
| 1659847168 | Assured Residential and Consulting, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5555 N Tacoma Ave Ste 101, Indianapolis, IN 46220-3551 | 2018-10-23 |
| 1427560002 | Swan Garden Home Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4906 Quail Ridge Ln, Indianapolis, IN 46254 | 2017-11-03 |
| 1477063923 | Gray Residential Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9660 Commerce Dr, Carmel, IN 46032-7641 | 2017-10-10 |
| 1518338664 | First Steps | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 57358 Sequoia Dr, Goshen, IN 46528-8829 | 2015-10-15 |
| 1497144042 | Jennifer Whitlow | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6710 Waverhill Dr, Indianapolis, IN 46217-9101 | 2015-01-21 |
| 1174948202 | New Roots Behavior Strategies LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13448 Fulton Drive, Fishers, IN 46038 | 2014-02-26 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46803 |
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| 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.