NATIONAL MENTOR HEATLTHCARE, LLC (NPI# 1104238773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104238773 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEATLTHCARE, LLC |
| Other Organization Name | FLORIDA MENTOR |
| Practice Address |
1204 W 13th St Panama City FL 32401-2015 |
| Mailing Address |
5850 Hiatus Rd Suite E Tamarac FL 33321-6425 |
| Practice Telephone | 8507850605 |
| Mailing Telephone | 9542833848 |
| Mailing Fax Number | 9547224101 |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |
| Authorized Official Name | JON FISHER (SENIOR EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3525880149 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Florida Mentor | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205248879 | National Mentor Heatlthcare, LLC | Intermediate Care Facility, Mentally Retarded | 2133 E 12th St, Lynn Haven, FL 32444-3109 | 2014-05-29 |
| 1568874139 | National Mentor Heatlthcare, LLC | Intermediate Care Facility, Mentally Retarded | 2603 State Ave, Panama City, FL 32405-4359 | 2014-05-29 |
| Street Address |
1204 W 13TH ST |
| City | PANAMA CITY |
| State | FL |
| Zip Code | 32401-2015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528105988 | Residential Crf, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1204 W 13th St, Panama City, FL 32401-2015 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760946727 | Panama City Drugs | Pharmacy | 3127 East Bus 98, Panama City, FL 32401 | 2019-01-24 |
| 1154813418 | Karl Roger Metzger | Pharmacist | 306 S Macarthur Ave, Panama City, FL 32401 | 2018-06-03 |
| 1942703905 | Muhammad Eckhaus | Acupuncturist | 2401 West 15th Street, Panama City, FL 32401 | 2018-03-15 |
| 1922534171 | Wolford Family Practice Inc | Nurse Practitioner | 1027 E Business Hwy 98, Panama City, FL 32401 | 2017-05-10 |
| 1508397381 | Shoreline Medical Solutions & Dme, LLC | Durable Medical Equipment & Medical Supplies | 405 W Oak Ave Ste B, Panama City, FL 32401 | 2017-03-23 |
| 1679027189 | David Lawrence Angier | Behavioral Analyst | 904 Flower Ave, Panama City, FL 32401 | 2016-08-12 |
| 1427422369 | Kathy Purdessy | Nurse Practitioner | 801 E 6th St Ste 604, Panama City, FL 32401 | 2015-11-16 |
| 1881015154 | Anesthesia Unlimited Inc | Nurse Anesthetist, Certified Registered | 801 E 6th Stret, Ste 205, Panama City, FL 32401 | 2014-01-03 |
| 1598193765 | Lashunda Sherese Thomas | Social Worker | 2711 W. 15th St., Panama City, FL 32401 | 2013-10-24 |
| 1144654153 | Raymond Dretti Pacheco | Licensed Practical Nurse | 509 N Center Ave, Panama City, FL 32401 | 2013-08-27 |
| Find all providers in zip 32401 | ||||
| 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 |
|---|---|---|---|---|
| 1144827296 | Florida Mentor II LLC | Intermediate Care Facility, Mentally Retarded | 1407 Lincoln Dr, Panama City, FL 32401-2870 | 2020-10-01 |
| 1568874139 | National Mentor Heatlthcare, LLC | Intermediate Care Facility, Mentally Retarded | 2603 State Ave, Panama City, FL 32405-4359 | 2014-05-29 |
| 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 | ||||
| City | PANAMA CITY |
| Zip Code | 32401 |
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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.