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
5802 BRECKENRIDGE PKWY STE 101, TAMPA, FL 33610-4265
(800) 388-5150
Mailing address
6600 FRANCE AVE S STE 350, EDINA, MN 55435-1810
(800) 388-5150
(952) 922-6885
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
09/10/2025
Last updated
09/10/2025
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