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NATIONAL MENTOR HEALTHCARE, LLC

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Company Details

Name: NATIONAL MENTOR HEALTHCARE, LLC
Jurisdiction: Rhode Island
Entity type: Foreign Limited Liability Company
Status: Cancelled
Date of Organization in Rhode Island: 22 Feb 2005 (20 years ago)
Date of Dissolution: 24 Sep 2024 (10 months ago)
Date of Status Change: 24 Sep 2024 (10 months ago)
Identification Number: 000146012
Place of Formation: DELAWARE
Purpose: HEALTH AND HUMAN SERVICES
Fictitious names: Rhode Island Mentor (trading name, 2005-06-22 - )
Principal Address: Google Maps Logo 6600 FRANCE AVENUE SOUTH SUITE 350, EDINA, MN, 55435, USA

Industry & Business Activity

NAICS

623210 Residential Intellectual and Developmental Disability Facilities

This industry comprises establishments (e.g., group homes, hospitals, intermediate care facilities) primarily engaged in providing residential care services for persons diagnosed with intellectual and developmental disabilities. These facilities may provide some health care, though the focus is room, board, protective supervision, and counseling. Learn more at the U.S. Census Bureau

Agent

Name Role Address
CORPORATION SERVICE COMPANY Agent 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA

MANAGER

Name Role Address
PHILIP ROBERTS KAUFMAN MANAGER 6600 FRANCE AVENUE SOUTH, SUITE 350 EDINA, MN 55435 USA
DAVID R. CALLEN MANAGER 6600 FRANCE AVENUE SOUTH, SUITE 350 EDINA, MN 55435 USA
DANNA M. SZWED MANAGER 6600 FRANCE AVENUE SOUTH, SUITE 350 EDINA, MN 55435 USA

National Provider Identifier

NPI Number:
1073637807
Certification Date:
2023-03-04

Authorized Person:

Name:
BRETT IAN COHEN
Role:
COO
Phone:

Taxonomy:

Selected Taxonomy:
251C00000X - Developmentally Disabled Services Day Training Agency
Is Primary:
No
Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

Fax:
6108252831
Fax:
4012320651

Filings

Number Name File Date
202460298340 Certificate of Cancellation 2024-09-24
202459135630 Amendment to Application for Registration 2024-08-29
202453756840 Annual Report 2024-05-02
202333913150 Annual Report 2023-04-25
202216859830 Annual Report 2022-05-04

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Date of last update: 11 Jul 2025

Sources: Rhode Island Department of State