NATIONAL MENTOR HEALTHCARE LLC


Address: 5754 Twin River Ln, Indianapolis, IN 46239-5802
Phone: 3175812380

NATIONAL MENTOR HEALTHCARE LLC (NPI# 1396051009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396051009
Entity Type Organization
Organization Name NATIONAL MENTOR HEALTHCARE LLC
Other Organization Name INDIANA MENTOR ADULT FOSTER CARE
Practice Address 5754 Twin River Ln
Indianapolis
IN 46239-5802
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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
IN PROVIDER NUMBER 200193830T 01

Other Provider/Organization Names

Other Name Type Code
Indiana Mentor Adult Foster Care Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1770055980 National Mentor Healthcare LLC Intermediate Care Facility, Mentally Retarded 1275 N Rainbow Loop, Lecanto, FL 34461-8893 2018-12-28
1689098030 National Mentor Healthcare LLC Community Based Residential Treatment Facility, Mental Illness 12502 N 85th Ln, Peoria, AZ 85381-5160 2014-02-05
1598005423 National Mentor Healthcare LLC Custodial Care Facility 6032 W 7th Ave, Gary, IN 46406-1314 2013-03-01
1932485174 National Mentor Healthcare LLC Community/Behavioral Health 400 Fisher Rd, Brevard, NC 28712-3895 2011-11-02
1588940720 National Mentor Healthcare LLC Community/Behavioral Health 601 Greenville Hwy, Brevard, NC 28712-9414 2011-11-02
1578872289 National Mentor Healthcare LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 820 E Tipton St, Seymour, IN 47274-3524 2010-09-29
1528375896 National Mentor Healthcare LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 10129 Penrith Dr, Indianapolis, IN 46229-1397 2010-09-08
1437466703 National Mentor Healthcare LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 116 S Carroll Ave, Michigan City, IN 46360-5341 2010-09-08
1982910675 National Mentor Healthcare LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 9740 E 21st St, Indianapolis, IN 46229-1708 2010-08-19
1457667164 National Mentor Healthcare LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 4005 Texas Pike, Spencer, IN 47460-7158 2010-08-19

Other Data Sources

Entity Type Entity Name Entity Address
Virginia Business Entities National Mentor Healthcare LLC The Mentor Network, 313 Congress St 5th Fl, Boston, Massachusetts 02210

Office Location

Street Address 5754 TWIN RIVER LN
City INDIANAPOLIS
State IN
Zip Code 46239-5802

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1033514880 Deanna Warren Behavioral Analyst 8355 Chesterhill Lane, Indianapolis, IN 46239 2014-10-22
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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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
1497144042 Jennifer Whitlow Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 6710 Waverhill Dr, Indianapolis, IN 46217-9101 2015-01-21
1659677839 Sycamore Rehab Services/hendricks Co. Arc, Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 10 W Hanna Ave, Indianapolis, IN 46217-5102 2011-02-04
1528375896 National Mentor Healthcare LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 10129 Penrith Dr, Indianapolis, IN 46229-1397 2010-09-08
1063728723 National Mentor Healthcare, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 6705 E 49th St, Indianapolis, IN 46226-2549 2010-08-19
1982910675 National Mentor Healthcare LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 9740 E 21st St, Indianapolis, IN 46229-1708 2010-08-19
1750538427 Roger Lee Higgins Jr. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 6104 W Lake South Dr, Apt A, Indianapolis, IN 46224-7647 2008-08-25
1821267576 Access LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 7437 Sharzad Pl, Indianapolis, IN 46227-5432 2008-02-27
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City INDIANAPOLIS
Zip Code 46239

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Dataset Information

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.

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