NATIONAL MENTOR HEALTHCARE NETWORK (NPI# 1013093616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013093616 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE NETWORK |
| Other Organization Name | FLORIDA MENTOR |
| Practice Address |
4550 Ricker Rd Jacksonville FL 32210-6308 |
| Mailing Address |
3258 Parkside Center Cir Tampa FL 33619-0907 |
| Practice Telephone | 9047780935 |
| Practice Fax Number | 9047788396 |
| Mailing Telephone | 8136301746 |
| Mailing Fax Number | 8136301903 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2016-12-19 |
| Authorized Official Name | PRISCILLA SCURRY (SR. ACCOUNT RECEIVABLE SPECIALIST) |
| Authorized Official Telephone | 6136307146 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4060096 | FL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 018500800 | 05 | |
| FL | 031258400 | 05 |
| Other Name | Type Code |
|---|---|
| Florida Mentor | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104335298 | National Mentor Healthcare Network | Community Based Residential Treatment Facility, Mental Illness | 2301 Atco Ave, Atco, NJ 08004-1714 | 2017-09-21 |
| 1366598484 | National Mentor Healthcare Network | Intermediate Care Facility, Mental Illness | 5808 Kinkaid Rd, Jacksonville, FL 32244-1034 | 2007-01-25 |
| Street Address |
4550 RICKER RD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32210-6308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326604729 | Finding Balance Counseling, LLC | Counselor | 4705 Palmer Ave, Jacksonville, FL 32210 | 2019-05-13 |
| 1609349620 | Jennifer Lash | Counselor | 4705 Palmer Avenue, Jacksonville, FL 32210 | 2019-01-03 |
| 1588147854 | Alan Craig Ashkinazy | Chiropractor | 5233 Ricker Rd Ste 102, Jacksonville, FL 32210 | 2018-09-12 |
| 1841781671 | Amanda Rodriguez-medina | Chiropractor | 6640 103rd St, Jacksonville, FL 32210 | 2018-05-29 |
| 1518457357 | Vicki Teal | Nurse Practitioner | 6488 103rd Street, Suite A, Jacksonville, FL 32210 | 2018-05-17 |
| 1811412539 | River City Companionship LLC | Clinic/Center | 7857 Delaroche Drive, Jacksonville, FL 32210 | 2017-08-03 |
| 1306366216 | Always Straight From The Heart | Homemaker | 6511 Betsy Court, Jacksonville, FL 32210 | 2017-06-21 |
| 1720538556 | Total Renal Care Inc | Clinic/Center | 5276 Blanding Blvd Ste 26, Jacksonville, FL 32210 | 2016-10-05 |
| 1700333978 | Recovery Counseling and More Inc | Clinic/Center | 4570 Saint Johns Ave, Ste B, Jacksonville, FL 32210 | 2016-09-06 |
| 1831645662 | Drucilla Young | Nurse's Aide | 1700 Blanding Blvd. 68n, Jacksonville, FL 32210 | 2016-08-31 |
| Find all providers in zip 32210 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124628565 | Rachelle Homehealth Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8539 Gate Pkwy W Unit 9134, Jacksonville, FL 32216-1037 | 2020-10-26 |
| 1306459359 | Joy-little Enterprise LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9148 Ridge Blvd, Jacksonville, FL 32208-1265 | 2020-08-28 |
| 1346873882 | Cojo Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3825 Leonard Cir W, Jacksonville, FL 32209-3754 | 2020-02-12 |
| 1306497672 | Tamara Belcher-bostick | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2020 Almira St, Jacksonville, FL 32211-4604 | 2019-09-26 |
| 1235786856 | Mary Imhansiemhonehi | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4568 Antler Hill Dr E, Jacksonville, FL 32224-8704 | 2019-08-19 |
| 1942866611 | Linda R Siplin-kerrin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11855 Alexandra Dr, Jacksonville, FL 32218-8878 | 2019-05-17 |
| 1417414053 | Danx Group LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6859 Lenox Ave # 32, Jacksonville, FL 32205-6149 | 2019-03-01 |
| 1558834879 | Annquenette C Daniels | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6859 Lenox Ave Ste 32, Jacksonville, FL 32205-6149 | 2019-01-09 |
| 1730650573 | Turnaround Retreat | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1159 E 13th St, Jacksonville, FL 32206-3105 | 2018-12-05 |
| 1962982090 | Joyful Care, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6500 Lake Gray Blvd Apt 322, Jacksonville, FL 32244-7553 | 2018-08-17 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32210 |
Please comment or provide details below to improve the information on NATIONAL MENTOR HEALTHCARE NETWORK.
| 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.