institution
Indiana Mentor
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Indianapolis, Indiana
NPI 1407980170

Indiana Mentor is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Indianapolis, IN. Indiana Mentor practices in Indianapolis, IN. The NPI Number for Indiana Mentor is 1407980170 and holds a License No. 200193830 (Indiana).

The current practice location address for Indiana Mentor is 9000 Keystone Xing Ste 200, Indianapolis, IN and can be reached out via phone at 317-581-2380. You can also correspond with Indiana Mentor through the mailing address at 9000 KEYSTONE CROSSING STE 200, INDIANAPOLIS, IN - 46240-2148 (mailing address contact number: 317-208-7739).

Location: 9000 Keystone Xing Ste 200, Indianapolis, IN, 46240-2148
institution
Provider Profile Details
NPI Number
1407980170
Provider Name
Indiana Mentor
Credential
Provider Entity Type
Organization
Address
9000 Keystone Xing Ste 200, Indianapolis, IN, 46240-2148
Phone Number
317-581-2380
Fax Number
Provider Enumeration Date
03/15/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200193830 01 IN PROVIDER NUMBER
300033125 01 IN PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
9000 Keystone Xing Ste 200
City
State
Zip
46240-2148
Phone Number
317-581-2380
Fax Number
person
Provider Business Mailing Address Details
Address
9000 Keystone Xing Ste 200
City
State
Zip
46240-2148
Phone Number
317-581-2380
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
200193830 (Indiana)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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