# NATIONAL MENTOR HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Florida Mentor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144382136
- **Authorized official:** BRETT IAN COHEN (COO)
- **Authorized official phone:** (800) 388-5150

## Contact information

- **Practice address:** 111 NE CAPRONA AVE, PORT ST LUCIE, FL 34983-8450
- **Practice address phone:** (772) 879-1925
- **Mailing address:** 313 CONGRESS ST, BOSTON, MA 02210-1218
- **Mailing address phone:** (800) 388-5150
- **Mailing address fax:** (617) 790-4271

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 4017096 | FL | Yes |

## Other

- **Enumeration date:** 12/15/2006
- **Last updated:** 03/04/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0312657 | — | FL |