FLORIDA MENTOR II LLC
NPI 1427869809
Intermediate Care Facility, Intellectual Disabilities in Lake City, FL

Active since January 15, 2025CLIA 10D2342898 · Waiver
673 NW CLUSTER DR, LAKE CITY, FL 32055(800) 388-5150 Get Directions Write a Review

NPPES record last updated: January 15, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Florida Mentor Ii Llc NPPES

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

FLORIDA MENTOR II LLC (NPI 1427869809) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Lake City, Florida and active in the NPI registry since January 2025. The organization holds a CLIA Waiver certificate valid through April 27, 2028 and lists Mary Patricia Rodenberg-roberts, Vp & Sr Asst General Counsel, as its authorized official.

NPPES Registry Identity

NPI1427869809
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameFLORIDA MENTOR II LLC
Location Address673 NW CLUSTER DRLake City, FL 32055-2534
Mailing Address6600 France Ave S Ste 350Edina, MN 55435-1810 · (800) 388-5150
Organization SubpartNo
Authorized OfficialMary Patricia Rodenberg-robertsVp & Sr Asst General Counsel · (952) 836-2234
Enumeration DateJanuary 15, 2025
NPPES CertifiedJanuary 15, 2025
NPI 1427869809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

673 NW CLUSTER DR, Lake City, FL 32055

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 10D2342898

Florida Mentor II LLC · Lake City, FL
Active · expires Apr 27, 2028
CLIA Number10D2342898
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateApril 28, 2026
Certificate Expiration DateApril 27, 2028
Laboratory DirectorCara M. Farmer
Laboratory Phone(813) 293-1270
Laboratory LocationFlorida Mentor II LLC673 NW Cluster Drive, Lake City, FL 32055
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Intermediate Care Facility, Intellectual Disabilities
673 NW CLUSTER DR
LAKE CITY, FL 32055

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 Florida Mentor II LLC's NPI number?

The NPI number for Florida Mentor II LLC is 1427869809. It was assigned to this organization in the NPPES registry on January 15, 2025.

Where is Florida Mentor II LLC located?

Florida Mentor II LLC is located at 673 NW Cluster Dr, Lake City, FL 32055. The listed phone number is (800) 388-5150.

What is Florida Mentor II LLC's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Does Florida Mentor II LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2342898) is associated with this NPI, valid through April 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Florida Mentor II LLC was last updated on January 15, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.