NATIONAL MENTOR HEALTHCARE,LLC (NPI# 1720141542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720141542 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE,LLC |
| Practice Address |
3615 Hodges Blvd Jacksonville FL 32224-1288 |
| Practice Telephone | 9042234173 |
| Practice Fax Number | 9042235611 |
| Mailing Telephone | 9042234173 |
| Mailing Fax Number | 9042235611 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2008-07-01 |
| Authorized Official Name | MS. LOLANDA GAIL FRANCIS (ADMINISTRATOR) |
| Authorized Official Telephone | 9042234173 |
| 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 | 4034096 | FL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 0312592 00 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548315716 | National Mentor Healthcare,llc | Community/Behavioral Health | 5300 S Florida Ave, Suite 406, Lakeland, FL 33813-4921 | 2007-01-25 |
| 1831419134 | National Mentor Healthcare,llc | Foster Care Agency | 1890 Hudson Cir, Suite 12, Monroe, LA 71201-3538 | 2010-06-09 |
| 1689731127 | National Mentor Healthcare,llc | Community/Behavioral Health | 7700 N Kendall Dr, Suite 607, Miami, FL 33156-7564 | 2007-01-03 |
| Street Address |
3615 HODGES BLVD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224-1288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974372 | Noelle Parker | Specialist/Technologist | 1 Unf Drivve, Jacksonville, FL 32224 | 2020-02-18 |
| 1124685102 | Charcy Rene Stiller | Specialist/Technologist | 1 Unf Dr., Jacksonville, FL 32224 | 2019-05-24 |
| 1265097513 | Mayo Clinic Jacksonville | Ambulance | 13970 Zumbro Dr, Jacksonville, FL 32224 | 2019-05-02 |
| 1639681471 | Brigantti Anesthesia & Spine Care | Clinic/Center | 1361 13th Ave South Suite #210, Jacksonville, FL 32224 | 2017-11-02 |
| 1093240061 | Beric Emilio Berlioz | Anesthesiology | 4500 San Pablo Rd S # J, Jacksonville, FL 32224 | 2017-04-26 |
| 1609240746 | Matthew James Dailey | Nurse Anesthetist, Certified Registered | 2500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-11-29 |
| 1003299603 | Upscale Personal Care Home | Assisted Living Facility | 4375 Autumn River Road, Jacksonville, FL 32224 | 2015-07-01 |
| 1629459375 | Bellanid Fonseca | Social Worker | 3694 Summerlin Ln E, Jacksonville, FL 32224 | 2015-06-17 |
| 1164840500 | Nicholas Scotto | Physical Therapist | 11555 Central Pkwy Ste 1104, Jacksonville, FL 32224 | 2014-04-02 |
| 1497093454 | Quicker Care Urgent Care | Point of Service | 13770 Beach Blvd., Unit # 4, Jacksonville, FL 32224 | 2013-01-27 |
| Find all providers in zip 32224 | ||||
| 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 |
|---|---|---|---|---|
| 1184932956 | L'arche Harbor House, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 700 Arlington Rd N, Jacksonville, FL 32211-7306 | 2010-09-15 |
| 1649426065 | Marjorie G. Cupp | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1545 Parkwood St, Jacksonville, FL 32207-5476 | 2008-08-18 |
| 1447382387 | Houseofdavid | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 209 Toni Dr, Jacksonville, NC 28546-4803 | 2007-03-09 |
| 1528198892 | Hampton Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 Cypress Ct, Jacksonville, NC 28540-4029 | 2007-03-06 |
| 1497882195 | Genesis Therapeutic Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 99 Village Dr Ste 12, Jacksonville, NC 28546-7060 | 2007-02-28 |
| 1831224849 | Irving Family Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 112 Lance Ct, Jacksonville, NC 28546-8640 | 2007-02-22 |
| 1639204233 | Moore Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 232 Newport Dr, Jacksonville, NC 28540-4005 | 2007-02-22 |
| 1760971923 | Latrena M Thomas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 14091 Summer Breeze Dr E, Jacksonville, FL 32218-8913 | 2018-05-03 |
| 1265693584 | Linda Elizabeth Gibson | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 180 Coastal Ln, Jacksonville, NC 28546-6761 | 2008-06-19 |
| 1154465243 | Bushnell Dix Hill Jones 694110 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1201 S Main St, Jacksonville, IL 62650-3339 | 2007-02-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32224 |
Please comment or provide details below to improve the information on NATIONAL MENTOR HEALTHCARE,LLC.
| 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.