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
5300 S FLORIDA AVE, SUITE 406, LAKELAND, FL 33813-4921
(863) 607-4183
(863) 646-5843
Mailing address
313 CONGRESS ST, BOSTON, MA 02210-1218
(800) 388-5150
(617) 790-4271
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
766159200
—
FL
Enumeration date
01/25/2007
Last updated
03/12/2023
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