Organization
NATIONAL MENTOR HEALTHCARE INC
Active
Other names
Oklahoma MENTOR
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization
Contact information
Practice address
7615 E 63RD PL, THREE MEMORIAL PLACE, SUITE 130, TULSA, OK 74133-1244
(918) 254-6748
Mailing address
313 CONGRESS ST, BOSTON, MA 02210-1218
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
376J506
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100630280 A
—
OK
05
—
100630280 B
—
OK
05
—
100630280 C
—
OK
05
—
100630280 D
—
OK
05
—
100630280 E
—
OK
05
—
100630280 F
—
OK
05
—
100630280 G
—
OK
05
—
100630280 H
—
OK
05
—
100630280 I
—
OK
05
—
100630280 J
—
OK
05
—
100630280 K
—
OK
Enumeration date
05/11/2007
Last updated
03/05/2023
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