Arizona Mentor- Evergreen

LBN: National Mentor Healthcare, Llc
Arizona Mentor- Evergreen is an health care organization with primary practice located at 3838 N Central Ave Ste 1200 , Phoenix AZ 85012-1997. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as the primary health care specialty. National Mentor Healthcare, Llc can be contacted via phone (480) 646-6175, or through Cohen, Brett Ian via phone (800) 388-5150.

Contact Information

Primary practice address
3838 N Central Ave Ste 1200 Phoenix AZ 85012-1997
Phone: (480) 646-6175
Fax: (602) 567-2062
Website:
Map and Directions
Authorized official contact:
Name: Cohen, Brett Ian
Phone: (800) 388-5150

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X BH-3412 Arizona

Profile Details

NPI number 1003049487
LBN Legal business name National Mentor Healthcare, Llc
DBA Doing business as Arizona Mentor- Evergreen
Authorized official Cohen, Brett Ian
Entity Organization
Organization subpart 1 No
Enumeration date Sep 1st, 2009
Last updated May 14th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003049487 NPPES
Arizona MEDICAID 451471

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