NPI Registry.org

Indiana Mentor

NPI Registration Record

Provider / OrganizationNPIDate Certified
INDIANA MENTOR14079801702023-03-12

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)

Entity TypeOrganization
Provider OrganizationINDIANA MENTOR
Practice Office Address9000 KEYSTONE XING STE 200
INDIANAPOLIS, IN US
Practice Office Telephone3175812380
Mailing Address9000 KEYSTONE CROSSING STE 200
INDIANAPOLIS, IN 462402148 US
Business Telephone3172087739
Business Fax6177904271
Authorized OfficialBRETT IAN COHEN, COO
8003885150
HPT Codes
CodePractice
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
OPI Codes
200193830 OTHER IN PROVIDER NUMBER
300033125 OTHER IN PROVIDER NUMBER
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