NATIONAL MENTOR HEALTHCARE LLC (NPI# 1770055980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770055980 |
| Entity Type | Organization |
| Organization Name | NATIONAL MENTOR HEALTHCARE LLC |
| Other Organization Name | FLORIDA MENTOR |
| Practice Address |
1275 N Rainbow Loop Lecanto FL 34461-8893 |
| Mailing Address |
3258 Parkside Center Cir Tampa FL 33619-0907 |
| Practice Telephone | 3527463262 |
| Mailing Telephone | 8133898300 |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2019-01-24 |
| Authorized Official Name | EVE ESTRICT (QUALITY IMPROVEMENT MANAGER) |
| Authorized Official Telephone | 7326279890 |
| 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 |
|---|---|---|---|---|
| 1689098030 | National Mentor Healthcare LLC | Community Based Residential Treatment Facility, Mental Illness | 12502 N 85th Ln, Peoria, AZ 85381-5160 | 2014-02-05 |
| 1598005423 | National Mentor Healthcare LLC | Custodial Care Facility | 6032 W 7th Ave, Gary, IN 46406-1314 | 2013-03-01 |
| 1932485174 | National Mentor Healthcare LLC | Community/Behavioral Health | 400 Fisher Rd, Brevard, NC 28712-3895 | 2011-11-02 |
| 1588940720 | National Mentor Healthcare LLC | Community/Behavioral Health | 601 Greenville Hwy, Brevard, NC 28712-9414 | 2011-11-02 |
| 1578872289 | National Mentor Healthcare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 820 E Tipton St, Seymour, IN 47274-3524 | 2010-09-29 |
| 1528375896 | National Mentor Healthcare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10129 Penrith Dr, Indianapolis, IN 46229-1397 | 2010-09-08 |
| 1437466703 | National Mentor Healthcare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 116 S Carroll Ave, Michigan City, IN 46360-5341 | 2010-09-08 |
| 1982910675 | National Mentor Healthcare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9740 E 21st St, Indianapolis, IN 46229-1708 | 2010-08-19 |
| 1457667164 | National Mentor Healthcare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4005 Texas Pike, Spencer, IN 47460-7158 | 2010-08-19 |
| 1396051009 | National Mentor Healthcare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5754 Twin River Ln, Indianapolis, IN 46239-5802 | 2010-08-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | National Mentor Healthcare LLC | The Mentor Network, 313 Congress St 5th Fl, Boston, Massachusetts 02210 |
| Street Address |
1275 N RAINBOW LOOP |
| City | LECANTO |
| State | FL |
| Zip Code | 34461-8893 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891261160 | Shekinah Barfield | Physician Assistant | Pediatric and Internal Medicine Specialist Inc, 1990 N Prospect Ave, Lecanto, FL 34461 | 2018-10-15 |
| 1699240887 | Medical Risk Solutions | Family Medicine | 2804 W. Marc Knighton Court Key #10, Lecanto, FL 34461 | 2018-10-04 |
| 1851848097 | Pedim Outreach and Specialty Clinic LLC | Family Medicine | 1982 N Prospect Ave, Lecanto, FL 34461 | 2016-09-06 |
| 1265776579 | Wal-mart Stores East Lp | Technician/Technologist | 1936 N. Lecanto Hwy, Lecanto, FL 34461 | 2012-11-27 |
| 1922306109 | Pediatric and Internal Medicine Specialists, Pa | Clinic/Center | 1980 North Prospect Avenue, Lecanto, FL 34461 | 2011-03-11 |
| 1942459078 | Crq Enterprises LLC | Home Health | 4214 W Gulf To Lake Hwy, Lecanto, FL 34461 | 2008-09-12 |
| 1548418064 | Thomas Tybeck | Counselor | 324 S Kensington Ave Ste 328, Lecanto, FL 34461 | 2008-09-09 |
| 1356533566 | Amanda Nicole Coppedge | Optometrist | 240 N. Lecanto Hwy., Lecanto, FL 34461 | 2007-08-11 |
| 1679779185 | Brashears Vital Care Corp | Pharmacy | 471 N Dacie Pt, Lecanto, FL 34461 | 2007-06-22 |
| 1285751099 | Interim Healthcare Private Services, Inc. | Home Health | 581 E. Gulf To Lake Highway, Village West Plaza, Lecanto, FL 34461 | 2007-03-25 |
| Find all providers in zip 34461 | ||||
| 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 |
|---|---|---|---|---|
| 1215027925 | New Vue, LLC | Intermediate Care Facility, Mentally Retarded | 1275 N. Rainbow Loop, Lecanto, FL 34461 | 2006-10-13 |
| 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 |
| 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 |
| 1558533372 | Res-care Premier, Inc. | Intermediate Care Facility, Mentally Retarded | 12981 Sw 52nd St, Fort Lauderdale, FL 33330-2731 | 2008-04-01 |
| Find all providers with the same taxonomy | ||||
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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.