FORT WALTON BEACH DEVELOPMENTAL CENTER
NPI 1962009019
Intermediate Care Facility, Intellectual Disabilities in Fort Walton Beach, FL

Q: What is Florida Mentor II LLC's NPI number?

The NPI number for Florida Mentor II LLC is 1962009019. It was assigned to this organization in the NPPES registry on October 1, 2020. The provider is doing business as Fort Walton Beach Developmental Center.

Q: 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.

Active since October 01, 2020

1045 MAR WALT DR, FORT WALTON BEACH, FL 32547(850) 862-0108(850) 862-7103 Get Directions Write a Review

NPPES record last updated: November 18, 2020. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Nov 18, 2020, Oct 1, 2020 (2 updates tracked since 2020).

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About Fort Walton Beach Developmental Center NPPES

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

FORT WALTON BEACH DEVELOPMENTAL CENTER (NPI 1962009019) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Fort Walton Beach, Florida and active in the NPI registry since October 2020. The organization lists Carol Swanson, Vice President Of Operations, as its authorized official.

NPPES Registry Identity

NPI1962009019

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameFLORIDA MENTOR II LLC

Location Address1045 MAR WALT DRFort Walton Beach, FL 32547-6738

Mailing Address3258 Parkside Center CirTampa, FL 33619-0907 · (813) 389-8300

Phone(850) 862-0108

Fax(850) 862-7103

Organization SubpartYes

Authorized OfficialCarol SwansonVice President Of Operations · (813) 389-8300

Enumeration DateOctober 1, 2020

Last NPPES UpdateNovember 18, 20202 updates tracked since enumeration

NPPES CertifiedNovember 18, 2020

✔ NPI 1962009019 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.

1045 MAR WALT DR, Fort Walton Beach, FL 32547

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Other Names 1

Doing Business AsFort Walton Beach Developmental Center

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 1962009019. It was assigned to this organization in the NPPES registry on October 1, 2020. The provider is doing business as Fort Walton Beach Developmental Center.

Where is Florida Mentor II LLC located?

Florida Mentor II LLC is located at 1045 Mar Walt Dr, Fort Walton Beach, FL 32547. The listed phone number is (850) 862-0108.

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.

When was this NPI record last updated?

The NPPES record for Florida Mentor II LLC was last updated on November 18, 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.