Healthcare Provider Details

I. General information

NPI: 1073445508
Provider Name (Legal Business Name): NATIONAL MENTOR HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 N MERIDIAN ST STE 150
INDIANAPOLIS IN
46202-1429
US

IV. Provider business mailing address

6600 FRANCE AVE S STE 350
EDINA MN
55435-1810
US

V. Phone/Fax

Practice location:
  • Phone: 317-602-5587
  • Fax:
Mailing address:
  • Phone: 800-388-5150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

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