NATIONAL MENTOR HEALTHCARE, LLC (NPI# 1558510719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558510719 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE, LLC |
| Other Organization Name | ARIZONA MENTOR HAWTHORNE |
| Practice Address |
2700 N 3rd St Ste 4000 Phoenix AZ 85004-1173 |
| Mailing Address |
5621 S 51st Dr Laveen AZ 85339-1913 |
| Practice Telephone | 6022009494 |
| Mailing Telephone | 6022370405 |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2009-06-26 |
| Authorized Official Name | ELIZABETH RODGERS (DIRECTOR) |
| Authorized Official Telephone | 6022009494 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH 3163 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 434135 | 05 |
| Other Name | Type Code |
|---|---|
| Arizona Mentor Hawthorne | Doing Business As Name - Organization |
| 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 |
| 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 |
| Street Address |
2700 N 3RD ST STE 4000 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85004-1173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114070752 | National Mentor Healthcare | Day Training, Developmentally Disabled Services | 2700 N 3rd St Ste 4000, Phoenix, AZ 85004-1173 | 2007-01-18 |
| 1558691840 | National Mentor Healthcare LLC | Clinic/Center | 2700 N 3rd St Ste 4000, Phoenix, AZ 85004-1173 | 2010-01-08 |
| 1578764932 | Kelly Jenkins | Speech-Language Pathologist | 2700 N 3rd St Ste 4000, Phoenix, AZ 85004-1173 | 2007-05-31 |
| 1518168426 | Bethzaida Figueroa | Occupational Therapist | 2700 N 3rd St Ste 4000, Phoenix, AZ 85004-1173 | 2007-05-29 |
| 1932300860 | Karen Hanafin | Occupational Therapist | 2700 N 3rd St Ste 4000, Phoenix, AZ 85004-1173 | 2007-05-29 |
| 1164640959 | Alison C. Kozel | Speech-Language Pathologist | 2700 N 3rd St Ste 4000, Phoenix, AZ 85004-1173 | 2007-04-24 |
| 1215156674 | Connie Hunt | Speech-Language Pathologist | 2700 N 3rd St Ste 4000, Phoenix, AZ 85004-1173 | 2007-04-24 |
| 1912123605 | Darwyn Bartsch | Physical Therapist | 2700 N 3rd St Ste 4000, Phoenix, AZ 85004-1173 | 2007-04-18 |
| 1962543371 | Remaz Rehab | Home Health | 2700 N 3rd St Ste 4000, Phoenix, AZ 85004-1173 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396360749 | Ulivvo Inc. | Nurse Practitioner | 141 E Palm Lane, Suite 206, Phoenix, AZ 85004 | 2020-06-11 |
| 1508325929 | Ican America | Clinic/Center | Cityscape Tower 1 E Washington St., Suite 440, Phoenix, AZ 85004 | 2019-03-15 |
| 1770064107 | Edward Jude Stein | Pharmacist | Two Renaissance Square, 40 N Central Ave, Suite 780, Ihs Clinical Support Center, Phoenix, AZ 85004 | 2018-08-23 |
| 1740775303 | Alexander L. Shaw | Dentist | 201 N Central Ave. #1490, Phoenix, AZ 85004 | 2018-06-26 |
| 1497267868 | Michael Dimoff | Registered Nurse | 1850 N. Central Ave, Ste 1600, Phoenix, AZ 85004 | 2017-10-25 |
| 1093231433 | Ezequiel Bautista | Music Therapist | 2702 N 3rd Street, Suite 1000, Phoenix, AZ 85004 | 2017-08-17 |
| 1841742442 | Stacy Maahs | Nurse Practitioner | 500 N 3rd St Ste 155, Phoenix, AZ 85004 | 2016-10-29 |
| 1538537246 | Jessica Lindsay Karlson | Pharmacist | 2302 N Central Ave Ste 7, Phoenix, AZ 85004 | 2015-09-11 |
| 1689059883 | Yvette's Hope Foundation | Home Health | 40 N. Central Ave. Ste. 1400, Phoenix, AZ 85004 | 2015-07-29 |
| 1881082790 | Patricia Russell | Specialist/Technologist | 60 E. Vernon Ave, Arcadia Therapy Services, Phoenix, AZ 85004 | 2014-12-30 |
| Find all providers in zip 85004 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736018 | Happy Valley Community Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1106 E Cochise Dr, Phoenix, AZ 85020-1550 | 2020-10-05 |
| 1639782956 | Ascend Behavioral Health and Wellness,llc | Community Based Residential Treatment Facility, Mental Illness | 3308 W Desert Vista Trl, Phoenix, AZ 85083-5874 | 2020-08-26 |
| 1588281604 | Alliance Behavioral Care LLC | Community Based Residential Treatment Facility, Mental Illness | 1402 E Hoover Ave, Phoenix, AZ 85006-1737 | 2020-07-06 |
| 1174143846 | Alpine Villa LLC | Community Based Residential Treatment Facility, Mental Illness | 14414 N 29th St, Phoenix, AZ 85032-5004 | 2020-04-22 |
| 1346860657 | Semper Fidelis Behavioral Health & Counseling, LLC | Community Based Residential Treatment Facility, Mental Illness | 3606 E Baseline Rd Unit 288, Phoenix, AZ 85042-9617 | 2020-04-16 |
| 1548889793 | Shea Home LLC | Community Based Residential Treatment Facility, Mental Illness | 10435 N 40th St, Phoenix, AZ 85028-4043 | 2020-04-08 |
| 1699394858 | Acome Home LLC | Community Based Residential Treatment Facility, Mental Illness | 4509 E Acoma Dr, Phoenix, AZ 85032-4855 | 2020-04-08 |
| 1033748009 | Optimum Care of Arizona LLC | Community Based Residential Treatment Facility, Mental Illness | 717 E Harwell Rd, Phoenix, AZ 85042-6655 | 2020-04-02 |
| 1043846561 | Happy Haven Az LLC | Community Based Residential Treatment Facility, Mental Illness | 1110 W Hadley St, Phoenix, AZ 85007-3610 | 2020-03-16 |
| 1942835806 | Mercy Favor and Grace Social Services | Community Based Residential Treatment Facility, Mental Illness | 9431 W Sheridan St, Phoenix, AZ 85037-4435 | 2020-03-10 |
| Find all providers in PHOENIX | ||||
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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.