NPIMap

Organization Active NPI

National Mentor Healthcare, LLC

Doing business as Florida Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Pensacola, FL
National Provider Identifier
1831253780
Registry record updated Mar 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
4110096 Issued in FL
Legal business name
NATIONAL MENTOR HEALTHCARE, LLC
Doing business as
Florida Mentor
Practice address
9513 Barranger Dr
Pensacola, FL 32514-5423
Phone
(850) 479-2745
Fax
(850) 479-0957
NPI assigned
Dec 21, 2006
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 4110096 FL Primary

Addresses

Primary practice location

9513 Barranger Dr
Pensacola, FL 32514-5423

Mailing address

313 Congress St
Boston, MA 02210-1218
Phone (800) 388-5150

Other identifiers 1

IdentifierTypeStateIssuer
0312622-00MedicaidFL

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 1831253780. Details of each certification follow.

  • CCN 10G098 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 10G098

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
Jul 16, 1993
Last certification
Feb 11, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
9513 Barranger Drive
Pensacola, FL 32514

National Provider Directory

National Provider Directory
Tax ID family
Indiana Mentor336 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Locations

9460 University Pkwy
Pensacola, FL 32514
Phone (850) 478-2078

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679184000000",
    "number": "1831253780",
    "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": "9513 BARRANGER DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145423",
            "telephone_number": "850-479-2745",
            "fax_number": "850-479-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL MENTOR HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "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": "FL",
            "license": "4110096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0312622-00",
            "state": "FL"
        }
    ],
    "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 Pensacola, FL

Sources for this page

Verify at the official NPI Registry.