MEDICARE: NATIONAL MENTOR HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253J00000X	Foster Care Agency

General Provider Information

NPI Number	:	1073445508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL MENTOR HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	6600 FRANCE AVE S STE 350
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-1810
Country	:	US
Telephone Number	:	800-388-5150
Fax Number	:

Provider Business Practice Location Address
First Line	:	1630 N MERIDIAN ST STE 150
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-1429
Country	:	US
Telephone Number	:	317-602-5587
Fax Number	:

Authorized Official
Title or Position	:	CHIEF REGULATORY COUNSEL SR ASST GC
Name	:	MARY PATRICIA RODENBERG-ROBERTS
Credential	:
Telephone Number	:	952-836-2234

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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