Organization
NATIONAL MENTOR HEALTHCARE, LLC
Active
Other names
Indiana Mentor Adult Foster Care
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization
Contact information
Practice address
22557 COUNTY ROAD 104, ELKHART, IN 46514-9784
(317) 581-2380
Mailing address
313 CONGRESS ST, BOSTON, MA 02210-1218
(800) 388-5150
(617) 790-4271
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200943350F
PROVIDER NUMBER
IN
Enumeration date
09/29/2010
Last updated
03/04/2023
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