NATIONAL MENTOR HEALTHCARE, LLC (NPI# 1629113311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629113311 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE, LLC |
| Other Organization Name | NC MENTOR |
| Practice Address |
1400 Old Mill Cir Suite B Winston Salem NC 27103-2977 |
| Mailing Address |
3125 Poplarwood Court Suite 300 Raleigh NC 27604-6445 |
| Practice Telephone | 9197908580 |
| Practice Fax Number | 9197908065 |
| Mailing Telephone | 9197908580 |
| Mailing Fax Number | 9197908065 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2009-09-03 |
| Authorized Official Name | CHARLES DAVIS (STATE DIRECTOR) |
| Authorized Official Telephone | 9197908580 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 251K00000X | Public Health or Welfare | NC | Agencies | |
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8300268 | 05 |
| Other Name | Type Code |
|---|---|
| NC MENTOR | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730644725 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 4 Dogwood Ct, Hackettstown, NJ 07840-4800 | 2019-02-05 |
| 1568927556 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 143 Meadows Rd, Lafayette, NJ 07848-3120 | 2019-02-05 |
| 1548725534 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 23 Waterloo Rd, Stanhope, NJ 07874-3449 | 2019-02-05 |
| 1891250882 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 4 Tall Oaks Rd, Somerset, NJ 08873-3033 | 2019-02-05 |
| 1154886141 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 15 Rockleigh Dr, Ewing, NJ 08628-1516 | 2019-02-05 |
| 1366907354 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 23 Pritchard Ln, Sicklerville, NJ 08081-2013 | 2019-02-05 |
| 1114482007 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 270 Smithburg Rd, Manalapan, NJ 07726-8122 | 2019-02-05 |
| 1376008367 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 521 Townsbury Rd, Great Meadows, NJ 07838-2043 | 2019-02-05 |
| 1225593213 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 266 Jackson Mills Rd, Freehold, NJ 07728-8057 | 2019-02-05 |
| 1790235539 | National Mentor Healthcare, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 8 Dugans Grv, Millstone Twp, NJ 08535-8014 | 2016-10-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | NATIONAL MENTOR HEALTHCARE, LLC | 313 Congress St., Boston, MA 02210 |
| Indiana Business Entities | NATIONAL MENTOR HEALTHCARE, LLC | 313 Congress St, 5th Floor, Boston, MA 02210 |
| Street Address |
1400 OLD MILL CIR SUITE B |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-2977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942785068 | Metaspace Counseling Pllc | Social Worker | 1400 Old Mill Cir, Winston Salem, NC 27103-2977 | 2018-09-25 |
| 1770023038 | Magnolia Center for Counseling and Eating Recovery | Clinic/Center | 1400 Old Mill Cir, Suite B, Winston Salem, NC 27103-2977 | 2017-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407489529 | It Takes A Village Residential Care LLC | Community/Behavioral Health | 5008 Butterfield Dr, Winston Salem, NC 27105-3344 | 2020-02-17 |
| 1265070890 | Monarch | Community/Behavioral Health | 2680 Grosvenor Pl Apt 1, Winston Salem, NC 27106-5244 | 2019-12-13 |
| 1457810491 | Marilyn Marie Holder | Community/Behavioral Health | 3215 Linda Cir, Winston Salem, NC 27106-3023 | 2019-03-19 |
| 1306362017 | The Gracen Foundation | Community/Behavioral Health | 1140 Old Hollow Rd, Winston Salem, NC 27105-8709 | 2017-08-15 |
| 1720529357 | Rising Hope Clinical Assistance, LLC | Community/Behavioral Health | 510 Northgate Park Dr, Winston Salem, NC 27106 | 2017-03-15 |
| 1962940601 | Kenya Thornton | Community/Behavioral Health | 1225 East 5th, Suite 100, Winston Salem, NC 27101 | 2017-02-02 |
| 1881076446 | Monarch | Community/Behavioral Health | 967 Salisbury Ridge Rd, Winston Salem, NC 27127-3709 | 2015-06-19 |
| 1487032249 | Monarch | Community/Behavioral Health | 2844 Reynolda Rd, Winston Salem, NC 27106-3102 | 2015-05-13 |
| 1467839696 | Aria Health LLC | Community/Behavioral Health | 5312 Summit Heights Dr, Winston Salem, NC 27104-4479 | 2015-04-27 |
| 1194128629 | Valerie Benton Center | Community/Behavioral Health | 8 W 3rd St Ste 220, Winston Salem, NC 27101-3977 | 2014-09-29 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
Please comment or provide details below to improve the information on NATIONAL MENTOR HEALTHCARE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.