OrganizationActive
The Mentor Network
NPI 1972856011 · Intellectual Disabilities Intermediate Care Facility · Daytona Beach, FL
Provider details
- NPI number
- 1972856011
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Brett Cohen, Coo(800) 388-5150
- License
- 4021095 (FL)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1725 Fifth St
Daytona Beach, FL 32117-5107
Phone: (386) 274-4172
Fax: (386) 274-7629
Street-level locationGet directions
Mailing address
313 Congress St
Boston, MA 02210-1218
Other names (DBA / former)
- Doing business as
- Florida Mentor
- Doing business as
- Florida Mentor
Registry dates
- Enumerated
- 2012-10-25
- Last updated
- 2023-03-19
- Certified
- 2023-03-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.