Healthcare Provider Details

I. General information

NPI: 1528949906
Provider Name (Legal Business Name): MENTORS FOR FATHERLESS CHILDREN AND ABUSED FAMILIES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2804 BELCO DR
ORLANDO FL
32808-3557
US

IV. Provider business mailing address

3564 AVALON PARK EAST BLVD STE 1 SUITE 1 #3032
ORLANDO FL
32828-7365
US

V. Phone/Fax

Practice location:
  • Phone: 347-287-2244
  • Fax:
Mailing address:
  • Phone: 407-813-6099
  • Fax: 407-788-7851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: SAMARA JULES - ROBINSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 347-287-2244