Provider Demographics
NPI:1588456420
Name:NEXGEN MENTORS LLC
Entity type:Organization
Organization Name:NEXGEN MENTORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GLASS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:434-709-3581
Mailing Address - Street 1:1412 MILTON HWY
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:VA
Mailing Address - Zip Code:24586-2945
Mailing Address - Country:US
Mailing Address - Phone:434-709-3581
Mailing Address - Fax:
Practice Address - Street 1:1467 N MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-3755
Practice Address - Country:US
Practice Address - Phone:919-407-8696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No174200000XOther Service ProvidersMeals
No251V00000XAgenciesVoluntary or Charitable
No251X00000XAgenciesSupports Brokerage
No347E00000XTransportation ServicesTransportation Broker