Organization
NATIONAL MENTOR HEALTHCARE, LLC
Active
Parent organization
NATIONAL MENTOR SERVICES, LLC
Other names
Missouri MENTOR
Organization subpart
Yes
Provider details
NPI number
Legal business name
NATIONAL MENTOR SERVICES, LLC
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization
Contact information
Practice address
9375 DIELMAN INDUSTRIAL DR, OLIVETTE, MO 63132-2212
(314) 991-7944
(314) 991-6642
Mailing address
9375 DIELMAN INDUSTRIAL DR, OLIVETTE, MO 63132-2212
(314) 991-7944
(314) 991-6642
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
8002126
MO
Other
Enumeration date
12/07/2013
Last updated
03/05/2023
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