NATIONAL MENTOR HEALTHCARE LLC


Address: 116 S Carroll Ave, Michigan City, IN 46360-5341
Phone: 3175812380

NATIONAL MENTOR HEALTHCARE LLC (NPI# 1437466703) 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) 1437466703
Entity Type Organization
Organization Name NATIONAL MENTOR HEALTHCARE LLC
Other Organization Name INDIANA MENTOR ADULT FOSTER CARE
Practice Address 116 S Carroll Ave
Michigan City
IN 46360-5341
Mailing Address 8925 N Meridian St
Indianapolis
IN 46260-2386
Practice Telephone 3175812380
Mailing Telephone 3175812380
Mailing Fax Number 3175812378
Enumeration Date 2010-09-08
Last Update Date 2010-09-08
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 200193830S 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
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
1396051009 National Mentor Healthcare LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 5754 Twin River Ln, Indianapolis, IN 46239-5802 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 116 S CARROLL AVE
City MICHIGAN CITY
State IN
Zip Code 46360-5341

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1821649096 Trinity Healthcare Inc. Occupational Therapist 4300 Cleveland Ave, Michigan City, IN 46360 2019-09-27
1861905499 Erika Leigh Maroon Chiropractor 8690 West Pahs Rd., Michigan City, IN 46360 2017-11-06
1750740650 Michelle Asbell Nurse Practitioner 301 Homer St, Michigan City, IN 46360 2016-02-19
1235523952 Marnee Flinn-smith Specialist/Technologist 8466 Pahs Rd, Michigan City, IN 46360 2015-03-19
1184976359 Kelly Stewart Physical Therapist 301 Homer Street, Michigan City, IN 46360 2012-10-11
1053660936 Planned Parenthood of Indiana Michigan City Clinic/Center 324 Dunes Plaza, Michigan City, IN 46360 2012-09-06
1114288644 June R. R. Nichols Ocularist, Ltd Durable Medical Equipment & Medical Supplies 450 St. John Road, Suite 396, Michigan City, IN 46360 2012-05-31
1083980858 Enoch Kassa Internal Medicine 3777 N Frontage Rd, Michigan City, IN 46360 2012-03-27
1760768196 American Limb & Orthopedic Company of Valparaiso Prosthetic/Orthotic Supplier 3777 N. Frontage Rd, Suite 100, Michigan City, IN 46360 2011-10-31
1801181144 Elizabeth A Whitaker Counselor 8733 W. 400 N., 400 North Medical Center, Michigan City, IN 46360 2011-06-15
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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
1841449147 National Mentor Healthcare, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 806 Liberty Trl, Michigan City, IN 46360-2619 2008-09-11
1902115645 National Mentor Healthcare LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 214 Broadway St, Michigan City, IN 46360-5009 2010-09-29

Providers in the same taxonomy and state

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
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
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
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Competitor

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City MICHIGAN CITY
Zip Code 46360

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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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