NPIMap

Organization Active NPI

National Mentor Healthcare LLC

Doing business as Florida Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Lecanto, FL
National Provider Identifier
1770055980
Registry record updated Mar 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
NATIONAL MENTOR HEALTHCARE LLC
Doing business as
Florida Mentor
Practice address
1275 N Rainbow Loop
Lecanto, FL 34461-8893
Phone
(352) 746-3262
NPI assigned
Dec 28, 2018
Last updated
Mar 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2023

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)CodeLicenseStatePrimary
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 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 1770055980. Details of each certification follow.

  • CCN 10G030 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

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 NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2200449National Mentor Healthcare LLC1275 N Rainbow Loop, Lecanto, FL 34461Certificate of waiverNov 15, 2026

National Provider Directory

National Provider Directory
Tax ID family
National Mentor Healthcare336 organizations share this tax ID, including this one

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.

View all 24

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"
        }
    ]
}

Other providers in Lecanto, FL

Sources for this page

Verify at the official NPI Registry.