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MELLOW JAC
NPI 1396348082
Community/Behavioral Health in Kissimmee, FL

Active since November 17, 2020
108 LILAC DR, KISSIMMEE, FL 34743(407) 734-3417 Get Directions Write a Review

NPPES record last updated: November 17, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mellow Jac NPPES

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

MELLOW JAC (NPI 1396348082) is a healthcare organization registered as a community/behavioral health in Kissimmee, Florida and active in the NPI registry since November 2020. The organization lists Amie Pereira, Authorized Member, as its authorized official.

NPPES Registry Identity

NPI1396348082
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameMELLOW JAC
Location Address108 LILAC DRKissimmee, FL 34743-6345
Mailing Address108 Lilac DrKissimmee, FL 34743-6345 · (407) 734-3417
Phone(407) 734-3417
Organization SubpartNo
Authorized OfficialAmie PereiraAuthorized Member · (407) 615-0448
Enumeration DateNovember 17, 2020
NPPES CertifiedNovember 17, 2020
✔ NPI 1396348082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Also ListedBehavior AnalystTaxonomy 103K00000X
108 LILAC DR, Kissimmee, FL 34743
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMIE PEREIRA
Behavior Technician
108 LILAC DR
KISSIMMEE, FL 34743
Osceola County (407) 615-0448

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 Mellow Jac's NPI number?

The NPI number for Mellow Jac is 1396348082. It was assigned to this organization in the NPPES registry on November 17, 2020.

Where is Mellow Jac located?

Mellow Jac is located at 108 Lilac Dr, Kissimmee, FL 34743. The listed phone number is (407) 734-3417.

What is Mellow Jac's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Mellow Jac was last updated on November 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.