NPIMap

Organization Active NPI

Mentor Abi, LLC

  • Assisted Living Facility
  • Tyler, TX
National Provider Identifier
1043322308
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
136544 Issued in TX
Legal business name
MENTOR ABI, LLC
Practice address
6589 Oak Hill Blvd
Tyler, TX 75703
Phone
(501) 707-3262
Fax
(501) 753-8204
NPI assigned
Aug 31, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Cindy Beaty
Title
Accounts Receivable Analyst
Phone
(501) 707-3262

Corporate family (same tax ID) 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2240284Neurorestorative Texas6589 Oak Hill Blvd, Tyler, TX 75703Certificate of waiverOct 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Mentor Abi (37 organizations share this tax ID)

Locations

223 W Anderson Ln
Austin, TX 78752

11103 West Ave
Ste 309
San Antonio, TX 78213

2101 Lockhill Selma Rd
San Antonio, TX 78213

6589 Oak Hill Blvd
Tyler, TX 75703
Phone (501) 707-3262

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 136544 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

6589 Oak Hill Blvd
Tyler, TX 75703

Mailing address

280 Merrimack St Ste 600
Lawrence, MA 01843-1779
Phone (978) 655-2363

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
HH0996OtherTXBC-BS OF TX

Other names 1

NPPES NPI Registry
  • NeuroRestorative Texas Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 4, 2021.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633305600000",
    "number": "1043322308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 MERRIMACK ST STE 600",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431779",
            "telephone_number": "978-655-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6589 OAK HILL BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "501-707-3262",
            "fax_number": "501-753-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTOR ABI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-10-04",
        "certification_date": "2021-09-20",
        "status": "A",
        "authorized_official_last_name": "BEATY",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE ANALYST",
        "authorized_official_telephone_number": "501-707-3262",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "136544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC-BS OF TX",
            "identifier": "HH0996",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NeuroRestorative Texas",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NeuroRestorative Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.