Provider Demographics
NPI:1467330506
Name:MENTOR OPERATOR, LLC
Entity type:Organization
Organization Name:MENTOR OPERATOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSIRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-246-3937
Mailing Address - Street 1:6801 ENERGY CT STE 101
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34240-5816
Mailing Address - Country:US
Mailing Address - Phone:949-878-1324
Mailing Address - Fax:
Practice Address - Street 1:8155 MENTOR HILLS DR
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-7862
Practice Address - Country:US
Practice Address - Phone:440-294-8371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MENTOR HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility