Organization
CALIFORNIA MENTOR
Active
Organization
CALIFORNIA MENTOR
Active
Parent organization
NATIONAL MENTOR HEALTHCARE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NATIONAL MENTOR HEALTHCARE, LLC
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization
Contact information
Practice address
9166 ANAHEIM PL, SUITE 200, RANCHO CUCAMONGA, CA 91730-8541
(909) 483-2505
Mailing address
9166 ANAHEIM PL, SUITE 200, RANCHO CUCAMONGA, CA 91730-8541
(909) 483-2505
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/28/2013
Last updated
03/05/2023
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