OrganizationActive
Indiana Mentor
NPI 1407980170 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Indianapolis, IN
Provider details
- NPI number
- 1407980170
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Mary Rodenberg-Roberts, Vp & Sr. Asst General Counsel(952) 836-2234
- License
- 200193830 (IN)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 200193830 (IN)
Residential Treatment Facilities
Practice location
9000 Keystone Xing Ste 200
Indianapolis, IN 46240-2148
Phone: (317) 581-2380
Approximate (ZIP-level) locationGet directions
Mailing address
8777 Purdue Rd Ste 360
Indianapolis, IN 46268-3121
Registry dates
- Enumerated
- 2007-03-15
- Last updated
- 2024-12-23
- Certified
- 2024-12-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.