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NPI Code Detail

MEDICARE: NATIONAL MENTOR HEALTHCARE, LLC

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
1251S00000XCommunity/Behavioral Health AgencyCSA09ADHS0181AZ

General Provider Information

NPI Number : 1114152394
Entity Type Code : Organization
Provider Name (Legal Business Name) : NATIONAL MENTOR HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 3838 N CENTRAL AVE STE 1200
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-1997
Country : US
Telephone Number : 480-646-6175
Fax Number : 617-790-4271
Provider Business Practice Location Address
First Line : 2700 N 3RD ST
Second Line : #4000
City : PHOENIX
State : AZ
Zip : 85004-1129
Country : US
Telephone Number : 602-567-2012
Fax Number : 602-567-2062
Authorized Official
Title or Position : VP & SR ASST GENERAL COUNSEL
Name : MARY PATRICIA RODENBERG-ROBERTS
Credential :
Telephone Number : 952-836-2234
Provider Enumeration Date : 05/18/2009
Last Update Date : 08/21/2025

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Directions to “NATIONAL MENTOR HEALTHCARE, LLC ” Practice Location

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