NATIONAL MENTOR HEALTHCARE, LLC (NPI# 1942347083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942347083 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE, LLC |
| Other Organization Name | FLORIDA MENTOR |
| Practice Address |
55 E. College Dr. Avon Park FL 33825 |
| Mailing Address |
55 East College Dr. Avon Park FL 33825-9562 |
| Practice Telephone | 8634525141 |
| Practice Fax Number | 8634526514 |
| Mailing Telephone | 8634525141 |
| Mailing Fax Number | 8634526514 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. RICHARD T. BATES (PROGRAM MANAGER) |
| Authorized Official Telephone | 8634525141 |
| Authorized Official Credential | B.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 4012095 | FL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| FLORIDA MENTOR | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730644725 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 4 Dogwood Ct, Hackettstown, NJ 07840-4800 | 2019-02-05 |
| 1568927556 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 143 Meadows Rd, Lafayette, NJ 07848-3120 | 2019-02-05 |
| 1548725534 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 23 Waterloo Rd, Stanhope, NJ 07874-3449 | 2019-02-05 |
| 1891250882 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 4 Tall Oaks Rd, Somerset, NJ 08873-3033 | 2019-02-05 |
| 1154886141 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 15 Rockleigh Dr, Ewing, NJ 08628-1516 | 2019-02-05 |
| 1366907354 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 23 Pritchard Ln, Sicklerville, NJ 08081-2013 | 2019-02-05 |
| 1114482007 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 270 Smithburg Rd, Manalapan, NJ 07726-8122 | 2019-02-05 |
| 1376008367 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 521 Townsbury Rd, Great Meadows, NJ 07838-2043 | 2019-02-05 |
| 1225593213 | National Mentor Healthcare, LLC | Psychiatric Residential Treatment Facility | 266 Jackson Mills Rd, Freehold, NJ 07728-8057 | 2019-02-05 |
| 1790235539 | National Mentor Healthcare, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 8 Dugans Grv, Millstone Twp, NJ 08535-8014 | 2016-10-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | NATIONAL MENTOR HEALTHCARE, LLC | 313 Congress St., Boston, MA 02210 |
| Indiana Business Entities | NATIONAL MENTOR HEALTHCARE, LLC | 313 Congress St, 5th Floor, Boston, MA 02210 |
| Street Address |
55 E. COLLEGE DR. |
| City | AVON PARK |
| State | FL |
| Zip Code | 33825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528537610 | Cristina Marie Rivera | Physical Therapy Assistant | 1010 Us-27, Avon Park, FL 33825 | 2018-11-19 |
| 1417404021 | Tamara Jean Pierre IIi | Home Health | 742 S Fair View Terr, Avon Park, FL 33825 | 2016-09-01 |
| 1700017118 | Highlands Advanced Rheumatology and Arthritis Center Pl | Internal Medicine | 596 Us 27 N, Avon Park, FL 33825 | 2009-08-03 |
| 1508803925 | Tina Mclean | Physician Assistant | 1006 West Pleasant Street, Avon Park, FL 33825 | 2006-06-02 |
| 1265901292 | Stephanie Marie De Silva | Speech-Language Pathologist | 1010 Us-27, Avon Park, FL 33825 | 2018-11-20 |
| 1831684430 | Elizabeth Rauch | Nurse Practitioner | 950 County Road 17a W, Avon Park, FL 33825 | 2018-06-26 |
| 1093200693 | Sasha Arbona | Nurse Practitioner | 1659 Us Highway 27 N Unit 102, Avon Park, FL 33825 | 2018-06-26 |
| 1336649144 | Teresa Pierre Mcdowall | Nurse Practitioner | 950 County Road 17a W, Avon Park, FL 33825 | 2018-02-19 |
| 1851700553 | Marisol Caraballo | Internal Medicine | 596 Us Highway 27 N, Avon Park, FL 33825 | 2014-08-06 |
| 1801178330 | Albert Saez | Psychiatry & Neurology | 950 County Road 17a W, Avon Park, FL 33825 | 2011-09-10 |
| Find all providers in zip 33825 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962009019 | Florida Mentor II LLC | Intermediate Care Facility, Mentally Retarded | 1045 Mar Walt Dr, Fort Walton Beach, FL 32547-6738 | 2020-10-01 |
| 1952919557 | The Vinglo House LLC | Intermediate Care Facility, Mentally Retarded | 1862 Finn Hill Dr, Boynton Beach, FL 33426-9329 | 2020-07-20 |
| 1487290730 | Noal Group Home, Inc | Intermediate Care Facility, Mentally Retarded | 13379 Key Lime Blvd, West Palm Beach, FL 33412-2150 | 2019-11-21 |
| 1770055980 | National Mentor Healthcare LLC | Intermediate Care Facility, Mentally Retarded | 1275 N Rainbow Loop, Lecanto, FL 34461-8893 | 2018-12-28 |
| 1871993899 | Diomar Anover | Intermediate Care Facility, Mentally Retarded | 17812 Wendy Sue Ave, Hudson, FL 34667-5917 | 2014-08-27 |
| 1972856011 | The Mentor Network | Intermediate Care Facility, Mentally Retarded | 1725 Fifth St, Daytona Beach, FL 32117-5107 | 2012-10-25 |
| 1366798290 | Barc Housing Inc. | Intermediate Care Facility, Mentally Retarded | 2750 Sw 75th Ave, Davie, FL 33314-1008 | 2012-07-30 |
| 1255658365 | 98 | Intermediate Care Facility, Mentally Retarded | 11314 Mahopac Rd, Weeki Wachee, FL 34614-3562 | 2010-04-28 |
| 1245404250 | Marcia A. Howell | Intermediate Care Facility, Mentally Retarded | 17305 Blooming Fields Dr, Land O Lakes, FL 34638-7222 | 2008-04-22 |
| 1497928774 | New Vue LLC Dba Key Pine Village | Intermediate Care Facility, Mentally Retarded | 6457 W Norvell Bryant Hwy, Crystal River, FL 34429-9413 | 2008-04-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.