Active NPI
Mentor Abi, LLC
Doing business as Timber Ridge Ranch NeuroRestorative Center
- Rehabilitation Hospital
- Benton, AR
National Provider Identifier
1245342591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Hospital
- License
- 001
- Legal business name
- MENTOR ABI, LLC
- Doing business as
- Timber Ridge Ranch NeuroRestorative Center
- Practice address
- 15000 Highway 298
Benton, AR 72019-9282 - Phone
- (501) 758-8799
- Fax
- (501) 753-8204
- NPI assigned
- Aug 31, 2006
- Last updated
- Mar 18, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Patricia Rodenberg-Roberts
- Title
- VP & Sr Asst General Counsel
- Phone
- (952) 836-2234
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Hospital | 283X00000X | 001 | AR | Primary |
| Children's Rehabilitation Hospital | 283XC2000X | 10042 | AR | |
| Psychiatric Residential Treatment Facility | 323P00000X |
Addresses
Primary practice location
15000 Highway 298
Benton, AR 72019-9282
Mailing address
280 Merrimack St Ste 600
Lawrence, MA 01843-1779
Phone (501) 758-8799
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 181901125 | Medicaid | AR | |
| 181317526 | Medicaid | AR | |
| 1Z001 | Other | AR | BC/BS OF AR |
| 126843126 | Medicaid | AR | |
| 131121125 | Medicaid | AR |
Other names 1
- Timber Ridge Ranch NeuroRestorative Center
National Provider Directory
National Provider Directory- Tax ID family
- Mentor Abi LLC
Other organizations with this tax ID 36
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Timber Ridge Ranch NeuroRestorative Center
- Children's Rehabilitation Hospital
- Benton, AR
- NPI 1841414232
-
dba Oregon Orchid
- Mental Illness Community Based Residential Treatment Facility
- Portland, OR
- NPI 1558686576
-
dba NeuroRestorative Rhode Island
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Charlestown, RI
- NPI 1639476617
-
dba NeuroRestorative Wisconsin
- Mental Illness Community Based Residential Treatment Facility
- Waterford, WI
- NPI 1649574252
-
dba NeuroRestorative Maine
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Sebago, ME
- NPI 1033426739
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1742256000000",
"number": "1245342591",
"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": "501-758-8799",
"fax_number": "501-753-8204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15000 HIGHWAY 298",
"city": "BENTON",
"state": "AR",
"postal_code": "720199282",
"telephone_number": "501-758-8799",
"fax_number": "501-753-8204"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MENTOR ABI, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-31",
"last_updated": "2025-03-18",
"certification_date": "2025-03-18",
"status": "A",
"authorized_official_last_name": "RODENBERG-ROBERTS",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "PATRICIA",
"authorized_official_title_or_position": "VP & SR ASST GENERAL COUNSEL",
"authorized_official_telephone_number": "952-836-2234"
},
"taxonomies": [
{
"code": "283X00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Hospital",
"state": "AR",
"license": "001",
"primary": true
},
{
"code": "283XC2000X",
"taxonomy_group": "",
"desc": "Rehabilitation Hospital, Children",
"state": "AR",
"license": "10042",
"primary": false
},
{
"code": "323P00000X",
"taxonomy_group": "",
"desc": "Psychiatric Residential Treatment Facility",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "181901125",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "181317526",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF AR",
"identifier": "1Z001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "126843126",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "131121125",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Timber Ridge Ranch NeuroRestorative Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Timber Ridge Ranch NeuroRestorative Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Benton, AR
- Med Imaging of Arkansas, PLLC (Med Imaging of Arkansas)
- Medexpress Urgent Care Arkansas, P.a. (MedExpress Urgent Care - Benton, Military Rd)
- Robert Meek, RECOVERY ASSISTANT
- Christopher Meigs, LCSW
- Alexandra Mejia, RECOVERY ASSISTANT
- Mentor Abi, LLC (Timber Ridge Ranch NeuroRestorative Center)
- Victoria Grace Menzies
- Jessica Stevens Mercado, LMSW
- Alicia Meredith, RD
- Braden Meredith
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.