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FLORIDA MENTOR
NPI 1366598484
Intermediate Care Facility, Mental Illness in Jacksonville, FL

Active since January 25, 2007CLIA 10D0022925 · Waiver
5808 KINKAID RD, JACKSONVILLE, FL 32244(904) 777-0460(904) 778-9293 Get Directions Write a Review

NPPES record last updated: March 12, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 12, 2023, Aug 22, 2020 (2 updates tracked since 2020).

About Florida Mentor NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FLORIDA MENTOR (NPI 1366598484) is a healthcare organization registered as an intermediate care facility, mental illness in Jacksonville, Florida and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through December 1, 2026 and lists Brett Ian Cohen, Coo, as its authorized official.

NPPES Registry Identity

NPI1366598484
Entity TypeOrganization
Primary Taxonomy310500000X
Legal Business NameNATIONAL MENTOR HEALTHCARE NETWORK
Location Address5808 KINKAID RDJacksonville, FL 32244-1034
Mailing Address5808 Kinkaid RdJacksonville, FL 32244-1034 · (904) 777-0460 · Fax (904) 778-9293
Phone(904) 777-0460
Fax(904) 778-9293
Organization SubpartNo
Authorized OfficialBrett Ian CohenCoo · (800) 388-5150
Enumeration DateJanuary 25, 2007
Last NPPES UpdateMarch 12, 20232 updates tracked since enumeration
NPPES CertifiedMarch 12, 2023
✔ NPI 1366598484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Mental IllnessNursing & Custodial Care Facilities
Taxonomy Code310500000X
License✔ Licensed in FL · 4037095
Definition
A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness.
5808 KINKAID RD, Jacksonville, FL 32244
Open in Google Maps ↗

Other Names 1

Doing Business AsFlorida Mentor

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0022925

National Mentor Healthcare, Inc · Jacksonville, FL
Active · expires Dec 1, 2026
CLIA Number10D0022925
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateDecember 2, 2024
Certificate Expiration DateDecember 1, 2026
Laboratory DirectorNatalie Hunter
Laboratory Phone(904) 777-0460
Laboratory LocationNational Mentor Healthcare, Inc5808 Kinkaid Rd, Jacksonville, FL 32244
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is National Mentor Healthcare Network's NPI number?

The NPI number for National Mentor Healthcare Network is 1366598484. It was assigned to this organization in the NPPES registry on January 25, 2007. The provider is doing business as Florida Mentor.

Where is National Mentor Healthcare Network located?

National Mentor Healthcare Network is located at 5808 Kinkaid Rd, Jacksonville, FL 32244. The listed phone number is (904) 777-0460.

What is National Mentor Healthcare Network's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Mental Illness with taxonomy code 310500000X.

Does National Mentor Healthcare Network hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0022925) is associated with this NPI, valid through December 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for National Mentor Healthcare Network was last updated on March 12, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.