| NPI | 1275666018 |
|---|---|
| Doing Business As | INDIANA MENTOR |
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: IN 2524 B0030DE06) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2023-04-19 |