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General NPI Number Information
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NPI Number | 1588042733
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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 | 05/08/2015
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 4102 NW 2ND CT
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City | ANKENY
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State | IA
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Zip | 50023-6803
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Country | US
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Telephone | 618-203-6797
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2825
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City | CARBONDALE
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State | IL
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Zip | 62902-2825
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP & SR ASST GENERAL COUNSEL
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Name | MARY PATRICIA RODENBERG-ROBERTS
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Credential |
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Telephone | 952-836-2234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number |
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License Number State |
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