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
1726 N 100 W, HARTFORD CITY, IN 47348-9550
(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
05
—
200943350
—
IN
Enumeration date
05/17/2012
Last updated
03/19/2023
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