NATIONAL MENTOR HEALTHCARE, LLC


Address: 57155 White Pine Trl, South Bend, IN 46619-5584
Phone: 3175812380

NATIONAL MENTOR HEALTHCARE, LLC (NPI# 1497095327) 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) 1497095327
Entity Type Organization
Organization Name NATIONAL MENTOR HEALTHCARE, LLC
Other Organization Name INDIANA MENTOR ADULT FOSTER CARE
Practice Address 57155 White Pine Trl
South Bend
IN 46619-5584
Mailing Address 8925 N Meridian St
Suite 200
Indianapolis
IN 46260-2386
Practice Telephone 3175812380
Mailing Telephone 3175812380
Enumeration Date 2013-03-01
Last Update Date 2013-03-01
Authorized Official Name DAN MOHNKE (EXECUTIVE DIRECTOR)
Authorized Official Telephone 3175812380
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 311ZA0620X Custodial Care Facility
Specialization: Adult Care Home
Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
IN 200943350Y 05

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
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

Other Data Sources

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

Office Location

Street Address 57155 WHITE PINE TRL
City SOUTH BEND
State IN
Zip Code 46619-5584

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1578015103 Martin's Super Markets, Inc. Pharmacy 525 S. Mayflower Rd, South Bend, IN 46619 2016-10-31
1124449053 Sandra J Jackson Counselor 4218 Western Ave., South Bend, IN 46619 2013-12-19
1902227911 Patricia Ann Miller Counselor 4218 Western Ave, South Bend, IN 46619 2013-12-17
1740611953 Cynthia G. Finney Counselor 4218 Western Avenue, So Bend, IN 46619 2013-12-13
1437433406 Angela Nicole Zolvinski Pharmacist 4444 W. Western Ave, South Bend, IN 46619 2011-10-07
1871674556 The Health and Hospital Corporation of Marion County Skilled Nursing Facility 4600 W Washington St, South Bend, IN 46619 2006-10-18
1942302203 April Holtgren Family Medicine 1901 #b Western Ave, South Bend, IN 46619 2006-09-05
1447737002 Graciela Jimenez-martinez Registered Nurse 1901 #b Western Avenue, South Bend, IN 46619 2018-07-25
1821397878 Wright Dream In Home Supportive Care 706 S Sheridan St, South Bend, IN 46619 2011-03-16
1740439223 Scott J. Vanslambrouck Dentist 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46619 2008-09-09
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Taxonomy Information

Taxonomy Code 311ZA0620X
Grouping Nursing & Custodial Care Facilities
Classification Custodial Care Facility
Specialization Adult Care Home

Taxonomy Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1730650169 Benson Ngarambe Custodial Care Facility 719 Roland Ct, South Bend, IN 46601-3461 2018-12-11
1154611861 National Mentor Healthcare, LLC Custodial Care Facility 1434 Garland Cir, South Bend, IN 46614-2212 2011-04-14
1417267527 National Mentor Healthcare, LLC Custodial Care Facility 1057 E Johnson Rd, South Bend, IN 46614-5493 2010-10-08
1194034827 National Mentor Healthcare, LLC Custodial Care Facility 719 Haney Ave, South Bend, IN 46613-2609 2010-09-29
1285943993 National Mentor Healthcare, LLC Custodial Care Facility 4203 Fellows St, South Bend, IN 46614-2644 2010-09-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1093315095 Shana P Graham Custodial Care Facility 8308 E 11th St, Indianapolis, IN 46219-4003 2020-10-28
1629513700 Violet Johnson Custodial Care Facility 3213 N Riley Ave, Indianapolis, IN 46218-2350 2016-12-28
1477931764 Grace Adult Family Care LLC Custodial Care Facility 2947 N Colorado Ave, Indianapolis, IN 46218-3116 2015-05-07
1164852505 R&l Supportive Living Corp. Custodial Care Facility 3754 Jackson St, Gary, IN 46408-2226 2013-11-21
1932546959 National Mentor Healtcare LLC Custodial Care Facility 6323 Tennessee Ave, Hammond, IN 46323-1934 2013-05-31
1598005423 National Mentor Healthcare LLC Custodial Care Facility 6032 W 7th Ave, Gary, IN 46406-1314 2013-03-01
1821358342 National Mentor Healthcare, LLC Custodial Care Facility 1726 N 100 W, Hartford City, IN 47348-9550 2012-05-17
1669732186 National Mentor Healthcare, LLC Custodial Care Facility 2326 Flint Ct, Dyer, IN 46311-1913 2012-05-17
1720356082 National Mentor Healthcare, LLC Custodial Care Facility 210 Fox Orchard Run, Fort Wayne, IN 46825-6579 2011-12-01
1730456575 Amazing Grace Home Care LLC Custodial Care Facility 4825 W Beecher St, Indianapolis, IN 46241-4603 2011-11-22
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Competitor

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City SOUTH BEND
Zip Code 46619

Improve Information

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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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