NATIONAL MENTOR HEALTHCARE LLC (NPI# 1598005423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598005423 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE LLC |
| Other Organization Name | INDIANA MENTOR ADULT FOSTER CARE |
| Practice Address |
6032 W 7th Ave Gary IN 46406-1314 |
| Mailing Address |
8925 N Meridian St Suite 200 Indianapolis IN 46260-2386 |
| Practice Telephone | 3175812380 |
| Mailing Telephone | 3175812380 |
| Mailing Fax Number | 3175812378 |
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200943350X | 05 |
| 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 |
| 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 |
| 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 |
6032 W 7TH AVE |
| City | GARY |
| State | IN |
| Zip Code | 46406-1314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134380009 | Aspire Academy | Local Education Agency (LEA) | 4900 W 15th Ave, Gary, IN 46406 | 2008-06-23 |
| 1821118589 | Comprehensive Physical Therapy | Physical Therapist | 7501 W. 15th Ave, Gary, IN 46406 | 2007-03-29 |
| 1205973336 | Comprehensive Therapy, Inc. | Physical Therapist | 7501 W. 15th Ave., Gary, IN 46406 | 2007-01-30 |
| 1588603286 | Bryan Michael Buksar | Physical Therapist | 7101 West 17th Avenue, Gary, IN 46406 | 2006-06-06 |
| 1770960536 | Edgewater Systems for Balanced Living, Inc | Psychiatric Hospital | 4747 W 24th Ave, Gary, IN 46406 | 2015-04-30 |
| 1285753103 | Comprehensive Care | Preventive Medicine | 7501 W. 15th Ave., Gary, IN 46406 | 2007-03-29 |
| 1891832929 | Michael Foreit | General Practice | 7501 W. 15th Ave., Gary, IN 46406 | 2007-01-30 |
| 1740327873 | Frank Messana | General Practice | 7501 W. 15th Ave., Gary, IN 46406 | 2007-01-30 |
| 1760651863 | Tolanda Somerville | Speech-Language Pathologist | 5901 W 7th Ave, Gary, IN 46406-1311 | 2008-02-22 |
| 1598934697 | Lisa Previs | Developmental Therapist | 5901 W 7th Ave, Gary, IN 46406-1311 | 2008-02-22 |
| Find all providers in zip 46406 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164852505 | R&l Supportive Living Corp. | Custodial Care Facility | 3754 Jackson St, Gary, IN 46408-2226 | 2013-11-21 |
| 1609193770 | Sandra A Scott | Custodial Care Facility | 300 Taft St, Gary, IN 46404-1016 | 2010-04-28 |
| 1760608699 | Arc Bridges, Inc | Custodial Care Facility | 440 N Knox St, Gary, IN 46403-2093 | 2007-04-18 |
| 1578789475 | Arc Bridges Inc | Custodial Care Facility | 151 W 46th Ave, Gary, IN 46408-3905 | 2007-04-18 |
| 1003032939 | Arc Bridges, Inc | Custodial Care Facility | 401 S Union St, Gary, IN 46403-2658 | 2007-04-18 |
| 1568688497 | Arc Bridges, Inc | Custodial Care Facility | 4635 Pierce St, Gary, IN 46408-3810 | 2007-04-18 |
| 1386860211 | Arc Bridges, Inc | Custodial Care Facility | 2270 Ranburn Dr, Gary, IN 46408-2456 | 2007-04-18 |
| 1235355165 | Arc Bridges, Inc | Custodial Care Facility | 2901 Beverly Dr, Gary, IN 46408-1909 | 2007-04-18 |
| 1780809863 | Arc Bridges, Inc. | Custodial Care Facility | 300 W 53rd Ave, Gary, IN 46410-1412 | 2007-04-16 |
| 1548340920 | Oldies But Goodies Adult Day Care, Inc | Custodial Care Facility | 741 W 25th Ave, Same, Gary, IN 46407-3524 | 2006-10-17 |
| Find all providers in GARY | ||||
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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.