NATIONAL MENTOR HEALTHCARE, LLC (NPI# 1285943928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285943928 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE, LLC |
| Other Organization Name | INDIANA MENTOR |
| Practice Address |
15 Executive Dr Ste 1 Lafayette IN 47905-3833 |
| Mailing Address |
8925 N Meridian St Ste 200 Indianapolis IN 46260-2386 |
| Practice Telephone | 3175812380 |
| Mailing Telephone | 3175812380 |
| Mailing Fax Number | 3175812378 |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2010-09-29 |
| 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 | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | PROVIDER NUMBER | 200943350J | 01 |
| Other Name | Type Code |
|---|---|
| Indiana MENTOR | 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 |
15 EXECUTIVE DR STE 1 |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47905-3833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194756890 | Barbara A. Osborn | Social Worker | 15 Executive Dr, Ste 3, Lafayette, IN 47905-4868 | 2006-07-05 |
| 1689898447 | Lake Dermatology Inc. | Dermatology | 15 Executive Dr, Suite 4, Lafayette, IN 47905-3833 | 2007-04-12 |
| 1104848423 | Mark Adrian Lake | Dermatology | 15 Executive Dr, Suite 4, Lafayette, IN 47905-3833 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
| 1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
| 1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
| 1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
| 1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
| 1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
| 1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
| 1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
| 1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
| 1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
| Find all providers in zip 47905 | ||||
| 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 |
|---|---|---|---|---|
| 1558895144 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 185 Statesville Quarry Road, Lafayette, NJ 07848 | 2017-04-20 |
| 1861878894 | Willowglen Academy-new Jersey, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 61 Beaver Run Road, Lafayette, NJ 07848 | 2015-07-31 |
| 1821473471 | Broadstep Academy-new Jersey, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 84 Valley View Road, Lafayette, NJ 07848 | 2015-07-24 |
| 1487034567 | Scarc, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12 Valcourt Dr, Lafayette, NJ 07848-4624 | 2015-06-04 |
| 1285014357 | Scarc, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 210 Pelletown Rd, Lafayette, NJ 07848-3156 | 2015-06-04 |
| 1740660729 | Scarc, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 240 Warbasse Junction Rd, Lafayette, NJ 07848-4406 | 2015-06-04 |
| 1972854925 | Arc of Acadiana, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 503 Guidry St, Lafayette, LA 70501-8738 | 2012-09-29 |
| 1114250255 | Bedside Homecare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2900 Moss St Ste B, Lafayette, LA 70501-1268 | 2009-09-08 |
| 1639327992 | Bedside Homecare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1602 W Pinhook Rd Ste 209, Lafayette, LA 70508-3735 | 2008-08-28 |
| 1154453140 | Aguillard & Associates, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 707 Cedar Crest Ct, Lafayette, LA 70501-5525 | 2007-03-12 |
| Find all providers in LAFAYETTE | ||||
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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.