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Organization
NATIONAL MENTOR HEATLTHCARE, LLC
Active
Organization
NATIONAL MENTOR HEATLTHCARE, 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
2133 E 12TH ST, LYNN HAVEN, FL 32444-3109
(850) 785-0605
Mailing address
313 CONGRESS ST, BOSTON, MA 02210-1218
(800) 388-5150
(617) 790-4271
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
05/29/2014
Last updated
03/05/2023
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