NPIMap

Organization Active NPI

Florida Mentor II LLC

Doing business as Hillsborough County Developmental Center

  • Intellectual Disabilities Intermediate Care Facility
  • Tampa, FL
National Provider Identifier
1093322794
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
FLORIDA MENTOR II LLC
Doing business as
Hillsborough County Developmental Center
Practice address
14219 Bruce B Downs Blvd
Tampa, FL 33613-3913
Phone
(813) 971-3490
Fax
(813) 977-3471
NPI assigned
Sep 26, 2020
Last updated
Nov 18, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
FLORIDA MENTOR II LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carol Swanson
Title
Vice President of Operations
Phone
(813) 389-8300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X NU Primary

Addresses

Primary practice location

14219 Bruce B Downs Blvd
Tampa, FL 33613-3913

Mailing address

3258 Parkside Center Cir
Tampa, FL 33619-0907
Phone (813) 389-8300

Other names 1

  • Hillsborough County Developmental Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093322794. Details of each certification follow.

  • CCN 10G057 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 10G057

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
HILLSBOROUGH COUNTY DEVELOPMENTAL CENTER
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Apr 27, 1983
Last certification
Dec 5, 2024
Beds
64
Ownership / control type
Private (proprietary)
Facility address
14219 Bruce B Downs Blvd
Tampa, FL 33613

National Provider Directory

National Provider Directory
Tax ID family
Florida Mentor II LLC12 organizations share this tax ID, including this one
Part of
Florida Mentor II LLC

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1093322794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3258 PARKSIDE CENTER CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336190907",
            "telephone_number": "813-389-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14219 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133913",
            "telephone_number": "813-971-3490",
            "fax_number": "813-977-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA MENTOR II LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA MENTOR II LLC",
        "enumeration_date": "2020-09-26",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "813-389-8300"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillsborough County Developmental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.