The Mentor Network
Intermediate Care Facility, Intellectual Disabilities in Daytona Beach, Florida
1972856011- Practice location
- 1725 Fifth St, Daytona Beach, FL 32117-5107
- Phone
- 386-274-4172
- Fax
- 386-274-7629
- Last updated
- March 19, 2023
The Mentor Network is a healthcare organization based in Daytona Beach, FL. The Mentor Network practices in Daytona Beach, FL. The NPI Number for The Mentor Network is 1972856011 and holds a License No. 4021095 (FL). The current practice location address for The Mentor Network is 1725 Fifth St, Daytona Beach, FL 32117-5107 and can be reached out via phone at 386-274-4172 and via fax at 386-274-7629.
Provider Profile Details
- NPI Number
- 1972856011
- Provider Name
- The Mentor Network
- Provider Entity Type
- Organization
- Address
- 1725 Fifth St, Daytona Beach, FL 32117-5107
- Phone Number
- 386-274-4172
- Fax Number
- 386-274-7629
- Primary Taxonomy
- Intermediate Care Facility, Intellectual Disabilities · 315P00000X
- Organization Subpart
- No
- Authorized Official
- Brett Ian Cohen · Coo · 800-388-5150
- Other Names
- Florida Mentor (Doing Business As)
- Provider Enumeration Date
- October 25, 2012
- Last Update Date
- March 19, 2023
- Certification Date
- March 19, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1725 Fifth St
Daytona Beach, FL 32117-5107 - City
- Daytona Beach
- State
- Florida
- Zip
- 32117-5107
- Phone Number
- 386-274-4172
- Fax Number
- 386-274-7629
Provider Business Mailing Address Details
- Address
- 313 Congress St
Boston, MA 02210-1218 - City
- Boston
- State
- MA
- Zip
- 02210-1218
- Phone Number
- 800-388-5150
- Fax Number
- 617-790-4271
License Information
- License Number
- 4021095
- License State
- FL
- Taxonomy
- Intermediate Care Facility, Intellectual Disabilities · 315P00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of The Mentor Network?
The NPI number of The Mentor Network is 1972856011. It was assigned on October 25, 2012 and is currently active in the NPPES registry.
What is the specialty of The Mentor Network?
The Mentor Network is registered under the primary taxonomy Intermediate Care Facility, Intellectual Disabilities (code 315P00000X), licensed in FL under license number 4021095.
Where does The Mentor Network practice?
The practice location is 1725 Fifth St, Daytona Beach, FL 32117-5107. The office can be reached at 386-274-4172 (phone) or 386-274-7629 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1972856011 directly on the NPPES registry website.