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INDIANA MENTOR NPI 1407980170


NPI Information

NPI: 1407980170
Provider Name: INDIANA MENTOR
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
9000 KEYSTONE XING STE 200
INDIANAPOLIS, IN
ZIP 46240
Phone: (317) 581-2380
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INDIANA MENTOR is a community based residential treatment facility, intellectual and/or developmental disabilities in Indianapolis, IN. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. INDIANA MENTOR NPI is 1407980170. The provider is registered as an organization entity type.

The provider's business location address is:

9000 KEYSTONE XING STE 200
INDIANAPOLIS, IN
ZIP 46240-148
Phone: (317) 581-2380

The provider's authorized official is Brett Ian Cohen .
The authorized official title is Coo and has the following contact phone number (800) 388-5150.

The enumeration date for this NPI number is 3/15/2007 and was last updated on 3/12/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities200193830INDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200193830OTHERINDIANAPROVIDER NUMBER
2300033125OTHERINDIANAPROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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