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Organization
NATIONAL MENTOR HEALTHCARE, LLC
Active
Organization
NATIONAL MENTOR HEALTHCARE, LLC
Active
Other names
Florida Mentor
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization
Contact information
Practice address
111 NE CAPRONA AVE, PORT ST LUCIE, FL 34983-8450
(772) 879-1925
Mailing address
313 CONGRESS ST, BOSTON, MA 02210-1218
(800) 388-5150
(617) 790-4271
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
4017096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0312657
—
FL
Enumeration date
12/15/2006
Last updated
03/04/2023
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