Organization
NATIONAL MENTOR HEALTHCARE, 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
222 GREENRIDGE DR, PENSACOLA, FL 32514-3136
(850) 484-3276
(850) 479-0951
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
4111096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4111096
OPERATING LICENSE AHCA
FL
Enumeration date
12/21/2006
Last updated
03/05/2023
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