Organization · Type 2 NPI

National Mentor Healthcare, LLC

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Fort Wayne, IN

NPI number 1255647913 Active

Practice location

244 E Butler St
Fort Wayne, IN 46803-3308

Call (317) 581-2380 Map

Mailing address

313 Congress St
Boston, MA 02210-1218

Specialties and licenses

Taxonomy	Code	License
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary	320900000X	None listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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NPI record

NPI: 1255647913
Entity type: Organization (Type 2)
Issued: Aug 19, 2010
Last updated: Mar 5, 2023
Status: Active

Other names

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Indiana Mentor Adult Foster Care · doing business as
Indiana Mentor Adult Foster Care · doing business as

Authorized official

Brett Ian Cohen
COO
(800) 388-5150

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1255647913

National Mentor Healthcare, LLC's National Provider Identifier is 1255647913, issued on Aug 19, 2010. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Fort Wayne, IN. The record was last updated on Mar 5, 2023.