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).
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 |
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 | 200193830T | 01 |
Other Name | Type Code |
---|---|
Indiana Mentor Adult Foster Care | Doing Business As Name - Organization |
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 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Virginia Business Entities | National Mentor Healthcare LLC | The Mentor Network, 313 Congress St 5th Fl, Boston, Massachusetts 02210 |
Street Address |
5754 TWIN RIVER LN |
City | INDIANAPOLIS |
State | IN |
Zip Code | 46239-5802 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184223075 | Hope Transitional Services LLC | Behavioral Analyst | 10737 Jimmy Lake Dr, Indianapolis, IN 46239 | 2020-10-21 |
1750854873 | Brooke Stevenson | Student in an Organized Health Care Education/Training Program | 8431 Redfern South Drive, Indianapolis, IN 46239 | 2019-01-11 |
1316429764 | Rachel Rutledge | Occupational Therapist | 10335 Corydon Ct, Indianapolis, IN 46239 | 2018-09-02 |
1073042404 | Hearst Contracting Services Ltd | Transportation Broker | 8655 Shadow Ridge Lane, G, Indianapolis, IN 46239 | 2017-06-08 |
1033514880 | Deanna Warren | Behavioral Analyst | 8355 Chesterhill Lane, Indianapolis, IN 46239 | 2014-10-22 |
1972851566 | Breathing Space, Inc | Clinic/Center | 8627 Blue Marlin Drive, Indianapolis, IN 46239 | 2012-08-29 |
1831355668 | Hook-superx, L.L.C. | Durable Medical Equipment & Medical Supplies | 7935 Brookville Road, Indianapolis, IN 46239 | 2008-07-31 |
1780702407 | James Bryant Wines | Dentist | 3416 S Post Rd, Suite C, Indpls, IN 46239 | 2007-03-27 |
1699223461 | World Changing Nurses | Voluntary or Charitable | 1030 S Mitchner Ave, Indianapolis, IN 46239-1160 | 2016-09-21 |
1700892155 | Ardis Conrad Melloh | Dentist | 7101 Southeastern Ave, Indianapolis, IN 46239-1207 | 2006-07-31 |
Find all providers in zip 46239 |
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 |
---|---|---|---|---|
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 |
Find all providers in INDIANAPOLIS |
City | INDIANAPOLIS |
Zip Code | 46239 |
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.