| National Mentor Healthcare Llc, D.b.a. Pa Mentor | |
|
625 W Ridge Pike Bldg B, Suite 102 Conshohocken PA 19428-1180 | |
| (866) 271-1802 | |
| Not Available |
| Full Name | National Mentor Healthcare Llc, D.b.a. Pa Mentor |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 625 W Ridge Pike, Conshohocken, Pennsylvania |
| Authorized Official Name and Position | Brett Ian Cohen (COO) |
| Authorized Official Contact | 8003885150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| National Mentor Healthcare Llc, D.b.a. Pa Mentor 625 W Ridge Pike Bldg B, Suite 102 Conshohocken PA 19428-1180 Ph: () - | National Mentor Healthcare Llc, D.b.a. Pa Mentor 625 W Ridge Pike Bldg B, Suite 102 Conshohocken PA 19428-1180 Ph: (866) 271-1802 |
| NPI Number | 1487060638 |
|---|---|
| Provider Enumeration Date | 07/09/2014 |
| Last Update Date | 03/12/2023 |
| Certification Date | 03/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487060638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 201400 (Pennsylvania) | Primary |
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