Provider Demographics
NPI:1811195746
Name:MENTOR BEHAVIORAL HEALTH CARE INC
Entity Type:Organization
Organization Name:MENTOR BEHAVIORAL HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HANK
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:828-268-2172
Mailing Address - Street 1:249 WILSON DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-8781
Mailing Address - Country:US
Mailing Address - Phone:828-268-2172
Mailing Address - Fax:828-268-2173
Practice Address - Street 1:249 WILSON DR
Practice Address - Street 2:SUITE 5
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-8781
Practice Address - Country:US
Practice Address - Phone:828-268-2172
Practice Address - Fax:828-268-2173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC558103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301766GMedicaid
NC8301766BMedicaid
NC6006175Medicaid