MEDICARE: NATIONAL MENTOR HEALTH CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1710542741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL MENTOR HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	313 CONGRESS ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02210-1218
Country	:	US
Telephone Number	:	800-388-5150
Fax Number	:	617-790-4271

Provider Business Practice Location Address
First Line	:	3258 PARKSIDE CENTER CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-0907
Country	:	US
Telephone Number	:	813-630-1746
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	BRETT IAN COHEN
Credential	:
Telephone Number	:	800-388-5150

Provider Enumeration Date	:	05/06/2019
Last Update Date	:	03/19/2023

Similar Medicare Providers

1326980921 — URGIMED WEST LLC
Practice Location Address:

3242 PARKSIDE CENTER CIR
TAMPA, FL
33619-0907

Practice Phone: 813-819-7974
Practice Fax: 888-947-4627

1063512648 — MS. ISABELITA BAJARIAS FULTON ARNP
Practice Location Address:

3258 PARKSIDE CENTER CIR
TAMPA, FL
33619-0907

Practice Phone: 813-635-0595
Practice Fax: 813-635-0691

1861543803 — ACE ENDEAVORS LLC
Practice Location Address:

3258 PARKSIDE CENTER CIRCLE
TAMPA, FL
33619-0907

Practice Phone: 813-635-0595
Practice Fax: 813-635-0691

1679812150 — MEREDITH DAVIDSON BCBA
Practice Location Address:

3258 PARKSIDE CENTER CIR
TAMPA, FL
33619-0907

Practice Phone: 813-630-1746
Practice Fax:

1285455154 — PCC PRIMARY CARE LLC
Practice Location Address:

3258 PARKSIDE CENTER CIR
TAMPA, FL
33619-0907

Practice Phone: 813-995-7192
Practice Fax:

1932040532 — SHAYNA CADET
Practice Location Address:

1211 TECH BLVD
TAMPA, FL
33619-7846

Practice Phone: 239-822-0823
Practice Fax:

Directions to “NATIONAL MENTOR HEALTH CARE, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.