FLORIDA MENTOR (NPI# 1134285141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134285141 |
| Entity Type | Organization |
| Organization Name | FLORIDA MENTOR |
| Practice Address |
1725 5th Street Daytona Beach FL 32117-5107 |
| Mailing Address |
1725 Fifth St Daytona Beach FL 32117-5107 |
| Practice Telephone | 3862744172 |
| Practice Fax Number | 3862745568 |
| Mailing Telephone | 3862744172 |
| Mailing Fax Number | 3862745568 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. EDWARD DEMETRICE MONAGAN (ADMINISTRATOR) |
| Authorized Official Telephone | 3862744172 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | 03125760 | FL | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487039848 | Florida Mentor | Community/Behavioral Health | 5304 S Florida Ave Ste 206, Lakeland, FL 33813-4918 | 2015-07-28 |
| 1982886685 | Florida Mentor | Community/Behavioral Health | 2055 Wood St, Suite 118, Sarasota, FL 34237-7903 | 2007-12-04 |
| 1417003310 | Florida Mentor | Community/Behavioral Health | 3200 Sw 34th Ave, Bldg. 200 Suite 203, Ocala, FL 34474-7456 | 2007-01-25 |
| Street Address |
1725 5TH STREET |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-5107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811435126 | Senior Care Source, Inc. | Day Training, Developmentally Disabled Services | 410 S. Beach St., Suite 310, Daytona Beach, FL 32114 | 2017-02-07 |
| 1922369792 | United Cerebral Palsy of East Central Florida, Inc. | Day Training, Developmentally Disabled Services | 1100 Jimmy Ann Dr, Daytona Beach, FL 32117-3920 | 2012-06-07 |
| 1316132772 | Sma Healthcare Inc | Day Training, Developmentally Disabled Services | 225 Fentress Blvd Ste A, Daytona Beach, FL 32114-1203 | 2007-09-10 |
| 1689282071 | Lavonne Lewis | Day Training, Developmentally Disabled Services | 929 Marion St, Daytona Beach, FL 32114-6005 | 2020-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528361 | Where The Heart Is Home Care Services LLC | Day Training, Developmentally Disabled Services | 110 E Broad St Apt 204, Tampa, FL 33604-4132 | 2020-11-04 |
| 1801496674 | Brandon Martinez | Day Training, Developmentally Disabled Services | 1884 Sw 81st Way, Davie, FL 33324-4609 | 2020-10-29 |
| 1639779721 | The Unique Way LLC | Day Training, Developmentally Disabled Services | 1025 S Ohio Ave Apt 15, Lakeland, FL 33803-1283 | 2020-10-28 |
| 1821696394 | Devotion of Care LLC | Day Training, Developmentally Disabled Services | 1801 Nw 3rd St, Pompano Beach, FL 33069-2756 | 2020-10-15 |
| 1538767298 | Healthy Group Home Project, LLC. | Day Training, Developmentally Disabled Services | 849 Mulberry Ave, Panama City, FL 32401-2556 | 2020-10-15 |
| 1902404742 | Brite Life Adult Training Program, LLC | Day Training, Developmentally Disabled Services | 1300 Nw 95th St, Miami, FL 33147-3320 | 2020-10-14 |
| 1134727845 | Four Seasons Aba | Day Training, Developmentally Disabled Services | 6 Meridian Home Ln, Palm Coast, FL 32137-2402 | 2020-10-14 |
| 1760089429 | Helping Angels Thrive, Inc. | Day Training, Developmentally Disabled Services | 305 Providence Rd Apt 101, Brandon, FL 33511-4739 | 2020-10-06 |
| 1245847268 | Joshua R Grant | Day Training, Developmentally Disabled Services | 2405 Almeda St, Jacksonville, FL 32209-4632 | 2020-09-24 |
| 1417562257 | Peace of Mind Home Care Services | Day Training, Developmentally Disabled Services | 1102 Ray Charles Blvd Unit 314, Tampa, FL 33602-3050 | 2020-09-09 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
Please comment or provide details below to improve the information on FLORIDA MENTOR.
| 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.