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
1204 W 13TH ST, PANAMA CITY, FL 32401-2015
(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
03/04/2023
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