FLORIDA MENTOR
NPI 1205248879
Intermediate Care Facility, Intellectual Disabilities in Lynn Haven, FL
NPI Status: Active since May 29, 2014
Contact Information
2133 E 12TH ST
LYNN HAVEN, FL
ZIP 32444
Phone: (850) 785-0605
- Organization
- Intermediate Care Facility, Intellectual...
- CLIA Number: 10D2060167
- CLIA Cert. Type: Intermediate Care Facility for Mentally Retarded
- CLIA Exp. Date: 06-06-2025
About FLORIDA MENTOR
This page provides the complete NPI Profile along with additional information for Florida Mentor, a provider established in Lynn Haven, Florida operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1205248879 assigned on May 2014. The practitioner's primary taxonomy code is 315P00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Florida Mentor. The authorized official of this NPI record is Brett Ian Cohen (Coo)
- NPI
- 1205248879
- Provider Legal Name
- NATIONAL MENTOR HEATLTHCARE, LLC
- Other Organization Name
- FLORIDA MENTOR
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2133 E 12TH ST LYNN HAVEN, FL 32444
- Location Phone
- (850) 785-0605
- Mailing Address
- 313 CONGRESS ST BOSTON, MA 02210
- Mailing Phone
- (800) 388-5150
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-29-2014
- Last Update Date
- 03-05-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Intermediate Care Facility, Intellectual Disabilities
- Taxonomy Code
- 315P00000X
- Type
- Nursing & Custodial Care Facilities
- Taxonomy Description
- An intermediate care facility providing services for individuals with intellectual disabilities.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2060167
- Facility Type
- Intermediate Care Facility for Mentally Retarded
- Certificate Effective Date
- June 07, 2023
- Certificate Expiration Date
- June 06, 2025
- Laboratory Director
- SUZETTE K. STEWARD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Florida Mentor to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 0 | 5 | 2 | 4 | 8 | 8 | 7 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 0 | 5 | 4 | 4 | 16 | 8 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 0 + 5 + 4 + 4 + 1 + 6 + 8 + 1 + 4 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1205248879 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1235201534 | RESIDENTIAL CRF,INC Organization | Home Health | 2133 E 12TH ST LYNN HAVEN, FL 32444 (850) 271-5071 |
| 1316085699 | RESIDENTIAL CRF, INC Organization | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | 2133 E 12TH ST LYNN HAVEN, FL 32444 (850) 785-0605 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205248879, enumerated in the NPI registry as an "organization" on May 29, 2014
The provider is located at 2133 E 12th St Lynn Haven, Fl 32444 and the phone number is (850) 785-0605
This medical organization specializes in Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X
The provider's CLIA number is 10D2060167 for a "intermediate care facility for mentally retarded" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on May 29, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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