Healthcare Provider Details

I. General information

NPI: 1043581937
Provider Name (Legal Business Name): MENTOR ABI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2012
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 S WINSTON LN
CASTLE HILLS TX
78213-1827
US

IV. Provider business mailing address

280 MERRIMACK ST STE 600
LAWRENCE MA
01843-2159
US

V. Phone/Fax

Practice location:
  • Phone: 210-979-0830
  • Fax: 210-979-0842
Mailing address:
  • Phone: 978-655-2363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: MARY PATRICIA RODENBERG-ROBERTS
Title or Position: VP & SR ASST GENERAL COUNSEL
Credential:
Phone: 952-836-2234