Provider / Organization | NPI | Date Certified |
---|---|---|
INDIANA MENTOR | 1407980170 | 2023-03-12 |
The organization Indiana Mentor is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1407980170. Registration indicates Indiana Mentor is a provider of services with a specialization in Residential Treatment Facilities, Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities (Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities, Residential Treatment Facilities)
Code | Practice | License No State |
---|---|---|
320900000X PRIMARY | Residential Treatment Facilities Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Behavioral Health/Substance Abuse/Psychiatry Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Residential Treatment Facilities | 200193830
IN |
200193830 | OTHER | IN | PROVIDER NUMBER |
300033125 | OTHER | IN | PROVIDER NUMBER |