Massachusetts Mentor LLC
Foster Care Agency in Brockton, Massachusetts
1811021090- Practice location
- 1115 W Chestnut St Ste 202, Brockton, MA 02301-7501
- Phone
- 781-326-4207
- Fax
- 781-326-4654
- Last updated
- June 20, 2026
Massachusetts Mentor LLC is a healthcare organization based in Brockton, MA. Massachusetts Mentor LLC practices in Brockton, MA. The NPI Number for Massachusetts Mentor LLC is 1811021090 and holds a License No. 1615 (MA). The current practice location address for Massachusetts Mentor LLC is 1115 W Chestnut St Ste 202, Brockton, MA 02301-7501 and can be reached out via phone at 781-326-4207 and via fax at 781-326-4654.
Provider Profile Details
- NPI Number
- 1811021090
- Provider Name
- Massachusetts Mentor LLC
- Provider Entity Type
- Organization
- Address
- 1115 W Chestnut St Ste 202, Brockton, MA 02301-7501
- Phone Number
- 781-326-4207
- Fax Number
- 781-326-4654
- Primary Taxonomy
- Foster Care Agency · 253J00000X
- Organization Subpart
- No
- Authorized Official
- Mary Patricia Rodenberg-Roberts · Chief Regulatory Officer Sr Asst Gc · 952-836-2234
- Provider Enumeration Date
- March 16, 2007
- Last Update Date
- June 20, 2026
- Certification Date
- June 20, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1115 W Chestnut St Ste 202
Brockton, MA 02301-7501 - City
- Brockton
- State
- Massachusetts
- Zip
- 02301-7501
- Phone Number
- 781-326-4207
- Fax Number
- 781-326-4654
Provider Business Mailing Address Details
- Address
- 6600 France Ave S Ste 350
Edina, MN 55435-1810 - City
- Edina
- State
- MN
- Zip
- 55435-1810
- Phone Number
- 800-388-5150
License Information
- License Number (1)
- 1615
- License State (1)
- MA
- Taxonomy (1)
- Community/Behavioral Health · 251S00000X
- Taxonomy (2)
- In Home Supportive Care · 253Z00000X
- Taxonomy (3)
- Foster Care Agency · 253J00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Massachusetts Mentor LLC?
The NPI number of Massachusetts Mentor LLC is 1811021090. It was assigned on March 16, 2007 and is currently active in the NPPES registry.
What is the specialty of Massachusetts Mentor LLC?
Massachusetts Mentor LLC is registered under the primary taxonomy Foster Care Agency (code 253J00000X), licensed in MA under license number 1615.
Where does Massachusetts Mentor LLC practice?
The practice location is 1115 W Chestnut St Ste 202, Brockton, MA 02301-7501. The office can be reached at 781-326-4207 (phone) or 781-326-4654 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1811021090 directly on the NPPES registry website.