Active NPI
National Mentor Healthcare LLC
- Intellectual Disabilities Intermediate Care Facility
- Lecanto, FL
National Provider Identifier
1770055980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- Legal business name
- NATIONAL MENTOR HEALTHCARE LLC
- Practice address
- 1275 N Rainbow Loop
Lecanto, FL 34461-8893 - Phone
- (352) 746-3262
- NPI assigned
- Dec 28, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brett Ian Cohen
- Title
- Coo
- Phone
- (800) 388-5150
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | Primary |
Addresses
Primary practice location
1275 N Rainbow Loop
Lecanto, FL 34461-8893
Mailing address
313 Congress St
Boston, MA 02210-1218
Phone (800) 388-5150
Other names 1
- Florida Mentor
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Intermediate care facility for individuals with intellectual disabilities certification: CCN 10G030
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
- FLORIDA MENTOR
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Mar 13, 1981
- Last certification
- Dec 3, 2025
- Beds
- 48 (47 certified)
- Ownership / control type
- Private (proprietary)
- Facility address
- 1275 N Rainbow Loop
Lecanto, FL 34461
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2200449 | National Mentor Healthcare LLC | Certificate of waiver | Nov 15, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- California Mentor
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Community/Behavioral Health Agency
- Lakeland, FL
- NPI 1487039848
-
- Community/Behavioral Health Agency
- Sarasota, FL
- NPI 1982886685
-
- Community/Behavioral Health Agency
- Ocala, FL
- NPI 1801938790
-
- Foster Care Agency
- Stuart, FL
- NPI 1851546857
-
- Community/Behavioral Health Agency
- Lakeland, FL
- NPI 1972733749
-
- Behavior Analyst
- Tampa, FL
- NPI 1710542741
-
- Case Management Agency
- Ft Myers, FL
- NPI 1811039746
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Lantana, FL
- NPI 1639220619
-
- Community/Behavioral Health Agency
- Sarasota, FL
- NPI 1952704009
-
- Community/Behavioral Health Agency
- Ft Myers, FL
- NPI 1548388069
-
- Case Management Agency
- Plantation, FL
- NPI 1598955734
-
- Community/Behavioral Health Agency
- Maitland, FL
- NPI 1740324185
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545955200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1679184000000",
"number": "1770055980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 CONGRESS ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "022101218",
"telephone_number": "800-388-5150",
"fax_number": "617-790-4271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 N RAINBOW LOOP",
"city": "LECANTO",
"state": "FL",
"postal_code": "344618893",
"telephone_number": "352-746-3262"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NATIONAL MENTOR HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-12-28",
"last_updated": "2023-03-19",
"certification_date": "2023-03-19",
"status": "A",
"authorized_official_last_name": "COHEN",
"authorized_official_first_name": "BRETT",
"authorized_official_middle_name": "IAN",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "800-388-5150"
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Florida Mentor",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Florida Mentor",
"code": "3",
"type": "Doing Business As"
}
]
}
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- Jeffery Gray Moser, L.O., C.PED.
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- Katrina Naber, PA-C
- Ryan Ashley Najimian, OTR/L
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.