Organization
FLORIDA MENTOR II LLC
Active
Parent organization
FLORIDA MENTOR II LLC
Other names
Panama City Developmental Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA MENTOR II LLC
Authorized official
CAROL SWANSON (VICE PRESIDENT OF OPERATIONS)
(813) 389-8300
Entity
Organization
Contact information
Practice address
1407 LINCOLN DR, PANAMA CITY, FL 32401-2870
(850) 769-7636
(850) 522-8966
Mailing address
3258 PARKSIDE CENTER CIR, TAMPA, FL 33619-0907
(813) 389-8300
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
10/01/2020
Last updated
11/18/2020
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