NATIONAL MENTOR HEALTHCARE NETWORK (NPI# 1366598484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366598484 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE NETWORK |
| Other Organization Name | FLORIDA MENTOR |
| Practice Address |
5808 Kinkaid Rd Jacksonville FL 32244-1034 |
| Practice Telephone | 9047770460 |
| Practice Fax Number | 9047789293 |
| Mailing Telephone | 9047770460 |
| Mailing Fax Number | 9047789293 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. SHELBY WILSON SALTER (PROGRAM MANAGER) |
| Authorized Official Telephone | 9047770460 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | 4037095 | FL | Nursing & Custodial Care Facilities |
| 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 |
| 1013093616 | National Mentor Healthcare Network | Behavioral Analyst | 4550 Ricker Rd, Jacksonville, FL 32210-6308 | 2006-10-27 |
| Street Address |
5808 KINKAID RD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32244-1034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013478247 | Saul Medina | Contractor | 8421 Cheswick Oak Ave, Jacksonville, FL 32244 | 2019-03-29 |
| 1447765748 | Sudduth Vision Pllc | Optometrist | 8000 Parramore Rd., Jacksonville, FL 32244 | 2017-12-08 |
| 1144735556 | Costco Wholesale Corporation | Pharmacy | 8000 Parramore Rd, Jacksonville, FL 32244 | 2017-12-07 |
| 1003287814 | South Jacksonville Dental Pllc | Dentist | 8440 Blanding Blvd, Jacksonville, FL 32244 | 2015-10-20 |
| 1326444340 | Laurie Lynn Scheid | Nurse Practitioner | 7855 Argyle Forest Blvd Ste 601, Jacksonville, FL 32244 | 2014-11-18 |
| 1114322260 | Candy Sharon Lucero | Occupational Therapist | 8563-2 Argyle Business Loop, Jacksonville, FL 32244 | 2014-10-31 |
| 1780959817 | Senior Helpers | In Home Supportive Care | 6327 Argyle Forest Blvd, Suite 3, Jacksonville, FL 32244 | 2012-03-22 |
| 1093831505 | Eduardo R Paat Sr. | Marriage & Family Therapist | 63394 Argyle Forest Blvd, Jacksonville, FL 32244 | 2007-03-22 |
| 1760524060 | Lauren Claxton Shivers | Nurse Practitioner | 8351 Westport Road, Jacksonville, FL 32244 | 2007-02-13 |
| 1427113968 | John F Bibb | Dentist | 6001 4 Argyle Forest Blvd, Jacksonville, FL 32244 | 2006-12-26 |
| Find all providers in zip 32244 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902420854 | Sunrise Community, Inc. | Intermediate Care Facility, Mental Illness | 817 W Wheeler Rd, Brandon, FL 33510-2140 | 2020-06-05 |
| 1174050371 | Andre Morris | Intermediate Care Facility, Mental Illness | 338 Daniels Pointe Dr, Winter Garden, FL 34787-4347 | 2017-05-18 |
| 1184920605 | Carine Robert | Intermediate Care Facility, Mental Illness | 11999 Nw 13th St, Pembroke Pines, FL 33026-3878 | 2011-01-31 |
| 1710162466 | Natalie and Erik Tiltins | Intermediate Care Facility, Mental Illness | 17919 Hwy. 231, Fountain, FL 32438 | 2007-12-31 |
| 1417137225 | Natalie and Erik Tiltins | Intermediate Care Facility, Mental Illness | 17919 Highway 231, Fountain, FL 32438-0500 | 2007-11-08 |
| 1942489265 | Sunshine Acres Assisted Living Facility, Inc. | Intermediate Care Facility, Mental Illness | 2563 River Rd, Caryville, FL 32427-2013 | 2007-11-02 |
| 1699802207 | Priority Life Services, Corp | Intermediate Care Facility, Mental Illness | 707 S 19th Ave Apt 6, Hollywood, FL 33020-5400 | 2007-02-28 |
| 1578600094 | Hll of Miami Corp | Intermediate Care Facility, Mental Illness | 9441 Sw 27th Dr, Miami, FL 33165-3103 | 2007-01-31 |
| 1568461671 | Panama City Developmental Center | Intermediate Care Facility, Mental Illness | 1407 Lincoln Dr, Panama City, FL 32401-2870 | 2005-07-20 |
| 1609875160 | Tallahassee Developmental Center | Intermediate Care Facility, Mental Illness | 455 Appleyard Dr, Tallahassee, FL 32304-2808 | 2005-07-18 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32244 |
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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.