NATIONAL MENTOR HEALTHCARE LLC (NPI# 1457667164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457667164 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE LLC |
| Other Organization Name | INDIANA MENTOR ADULT FOSTER CARE |
| Practice Address |
4005 Texas Pike Spencer IN 47460-7158 |
| 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 | 200193830R | 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 |
| 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 |
| 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 |
4005 TEXAS PIKE |
| City | SPENCER |
| State | IN |
| Zip Code | 47460-7158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588173280 | Rebecca Roell | Specialist/Technologist | 622 W State Highway 46, Spencer, IN 47460 | 2017-09-25 |
| 1740739275 | Owen County Family Young Men's Christian Association | Health Educator | 1111 W. State Hwy 46, Spencer, IN 47460 | 2016-09-26 |
| 1164515748 | Corinne R Riebow | Counselor | 272 North Us Highway 231, Spencer, IN 47460 | 2006-10-02 |
| 1689952772 | Kenneth E Marshall | Family Medicine | 9 N Crane Ave, Spencer, IN 47460 | 2011-07-25 |
| 1649348459 | Owen County Emergency Medical Services | Ambulance | 333 West State Highway 46, Spencer, IN 47460-0372 | 2006-12-01 |
| 1043242951 | Christi Ryan | Social Worker | 909 W Hillside Ave, Spencer, IN 47460-0595 | 2006-07-07 |
| 1417089434 | Stephanie Beth Sare | Day Training/Habilitation Specialist | 650 N East St, Spencer, IN 47460-1007 | 2007-03-12 |
| 1174645915 | Julia M. Fine | Nurse Practitioner | 911 W Hillside Ave, Spencer, IN 47460-1119 | 2007-04-04 |
| 1881644672 | Betty Jean Lawrance | Social Worker | 909 W Hillside Ave, Spencer, IN 47460-1119 | 2006-05-11 |
| 1427418284 | Cindy Rhodenbaugh | Social Worker | 909 W Hillside Ave, Spencer, IN 47460-1119 | 2016-03-07 |
| Find all providers in zip 47460 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| Find all providers with the same taxonomy | ||||
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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.