Organization · Type 2 NPI

National Mentor Healthcare LLC

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Michigan City, IN

NPI number 1902115645 Active

Practice location

214 Broadway St
Michigan City, IN 46360-5009

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.

Other intellectual and/or developmental disabilities community based residential treatment facility providers in Michigan City

See all in Michigan City →

NPI record

NPI: 1902115645
Entity type: Organization (Type 2)
Issued: Sep 29, 2010
Last updated: Mar 19, 2023
Status: Active

Other names

<unavail>
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

Verify this record

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.

Is this your record? How to update it.

About NPI 1902115645

National Mentor Healthcare LLC's National Provider Identifier is 1902115645, issued on Sep 29, 2010. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Michigan City, IN. The record was last updated on Mar 19, 2023.