NPI 1013093616

National Mentor Healthcare Network

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Jacksonville, FL

Practice location

Address: 4550 Ricker Rd, Jacksonville, FL 32210-6308
Phone: (904) 778-0935
Fax: (904) 778-8396
Mailing address: 313 Congress St, Boston, MA 02210-1218

Authorised official

Name: Brett Ian Cohen
Title: Coo
Phone: (800) 388-5150

Registered specialties (2)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence 4060096 (FL)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Florida →

Behavior Analyst

Behavioral Health & Social Service Providers Taxonomy 103K00000X

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Registry record

NPI: 1013093616
Entity type: Organization
NPI issued: 27 Oct 2006
Record last updated: 4 Mar 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.