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Organization

NATIONAL MENTOR HEALTHCARE, LLC

Active
Other names
Georgia Mentor
Organization subpart
No

Provider details

NPI number
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization

Contact information

Practice address
18 EXECUTIVE PARK DR NE, SUITE 1823, ATLANTA, GA 30329-2206
(404) 728-1567
(404) 982-9877
Mailing address
18 EXECUTIVE PARK DR NE, SUITE 1823, ATLANTA, GA 30329-2206
(404) 728-1567
(404) 982-9877

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000498847A
GA
05
000498847AA
GA
05
000498847AB
GA
05
000498847I
GA
05
000498847K
GA
05
000498847N
GA
05
000498847Q
GA
05
000498847U
GA
05
000498847X
GA
05
000498847Y
GA
05
000498847Z
GA
Enumeration date
11/01/2006
Last updated
03/12/2023
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