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General NPI Number Information
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NPI Number | 1508913336
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Entity Type | Organization
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Legal Business Name | MENTOR ABI, LLC
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2408 E 81ST ST SUITE 2600
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City | TULSA
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State | OK
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Zip | 74137-4200
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Country | US
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Telephone | 918-477-5111
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Fax | 918-477-5199
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Provider Business Mailing Address
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Address Line | 4500 W COMMERCIAL DR
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-7055
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Country | US
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Telephone | 501-758-8799
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Fax | 501-753-8204
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Authorized Official
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Title or Position | DIRECTOR OF REIMBURSEMENT
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Name | CINDY A BEATY
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Credential |
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Telephone | 501-758-8799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | 2371
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License Number State | OK
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