NATIONAL MENTOR HEALTHCARE, LLC (NPI# 1144382136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144382136 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE, LLC |
| Other Organization Name | FLORIDA MENTOR |
| Practice Address |
111 Ne Caprona Ave Port St Lucie FL 34983-8450 |
| Mailing Address |
1000 Se 14th St Stuart FL 34996-4001 |
| Practice Telephone | 7728791925 |
| Mailing Telephone | 7722863900 |
| Mailing Fax Number | 7722868292 |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. VICKIE WILLIAMS (PROGRQAM MANAGER) |
| Authorized Official Telephone | 7722863900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4017096 | FL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 0312657 | 05 |
| Other Name | Type Code |
|---|---|
| Florida Mentor | Other Name - Individual/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 |
111 NE CAPRONA AVE |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34983-8450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588224109 | Skytop Transportation Inc | Non-emergency Medical Transport (VAN) | 6947 Nw Daffodil Ln, Port Saint Lucie, FL 34983 | 2019-06-17 |
| 1063985125 | Ralph Glen Manning | Counselor | 289 Se Sagamore Terrace, Port Saint Lucie, FL 34983 | 2019-01-10 |
| 1275032252 | Charlotte Simpkins | Nurse's Aide | 462 Se Faith Terrace, Port Saint Lucie, FL 34983 | 2018-02-06 |
| 1124547989 | Alicia Maria Herrero Marzo | Case Manager/Care Coordinator | 749 Nw Orchid St, Port St Lucie, FL 34983 | 2017-09-13 |
| 1922535137 | Superior Living 'llc' | Assisted Living Facility | 496 Southeast Verada, Port St Lucie, FL 34983 | 2017-05-18 |
| 1760931562 | Lisa A Joseph | Registered Nurse | 1602 Se Sandia Dr, Psl, FL 34983 | 2016-09-22 |
| 1891146270 | Janet Bayramyan | Counselor | 453 Nw Dover Ct, Port St Lucie, FL 34983 | 2016-06-27 |
| 1033565650 | Jennifer J Ramos | Physician Assistant | 1581 Sw Bayshore Blvd, Port St Lucie, FL 34983 | 2016-05-12 |
| 1659741379 | Amy Mae Dipalma | Physical Therapy Assistant | 5238 Nw Rugby Dr, Port St Lucie, FL 34983 | 2015-10-07 |
| 1942682406 | Vikash Dahya | Dentist | 499 Sw Prima Vista Blvd, Port St. Lucie, FL 34983 | 2015-06-22 |
| Find all providers in zip 34983 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699375485 | Violange Joseph | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3310 Sw Frankford St, Port St Lucie, FL 34953-4937 | 2020-10-29 |
| 1720437890 | Moses Group Home LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4273 Sw Dido Dr, Port St Lucie, FL 34953-6434 | 2016-06-08 |
| 1760894745 | Galette Group Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 528 Se Nome Dr, Port St Lucie, FL 34984-8942 | 2014-05-27 |
| 1871655746 | National Mentor Healthcare, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2318 Se Rich St, Port St Lucie, FL 34984-5125 | 2006-12-15 |
| 1114434289 | Heart To Heart Care LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 509 Sw Dahled Ave, Port St Lucie, FL 34953-4029 | 2018-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396461 | Hillendale Cares LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 27357 Frampton Ave, Brooksville, FL 34602-7306 | 2020-11-02 |
| 1407468986 | Winchester Oaks Corporation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 871 Winchester St, Daytona Beach, FL 32114-1977 | 2020-08-17 |
| 1609486844 | Aclaris Care Home, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 7711 N Rome Ave, Tampa, FL 33604-4615 | 2020-08-03 |
| 1386253987 | Rosa Estela Companioni | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6704 Commodore Way, Tampa, FL 33615-5810 | 2020-07-29 |
| 1972121192 | Victorian Manor, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11150 Sw 42nd Ct, Davie, FL 33328-2140 | 2020-07-14 |
| 1881233716 | Elizabeth Stapleton | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4628 25th St Sw, Lehigh Acres, FL 33973-6161 | 2019-12-23 |
| 1689217887 | Angelchild Homecare Corp Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1641 Sunset Point Rd, Clearwater, FL 33755-1657 | 2019-10-21 |
| 1659927325 | Coby Cares Corporation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1754 Barnstable Rd, Wellington, FL 33414-6143 | 2019-08-17 |
| 1518520725 | Freshen Schammua Docile | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9097 Sw 4th St, Boca Raton, FL 33433-4607 | 2019-04-15 |
| 1841752888 | Developing New Horizons | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1500 Nw 89th Ct Ste 111b, Doral, FL 33172-2640 | 2019-04-01 |
| Find all providers with the same taxonomy | ||||
| City | PORT ST LUCIE |
| Zip Code | 34983 |
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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.