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Organization
FLORIDA MENTOR II LLC
Active
Organization
FLORIDA MENTOR II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (VP & SR ASST GENERAL COUNSEL)
(952) 836-2234
Entity
Organization
Contact information
Practice address
673 NW CLUSTER DR, LAKE CITY, FL 32055-2534
(800) 388-5150
Mailing address
6600 FRANCE AVE S STE 350, EDINA, MN 55435-1810
(800) 388-5150
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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