| NPI | 1073645487 |
|---|---|
| Doing Business As | INDIANA MENTOR |
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IN 100249260) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2023-04-20 |