Active NPI
Mentor Abi
Doing business as NeuroRestorative Wisconsin
- Mental Illness Community Based Residential Treatment Facility
- Waterford, WI
National Provider Identifier
1649574252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- License
- 0013091
- Legal business name
- MENTOR ABI
- Doing business as
- NeuroRestorative Wisconsin
- Practice address
- 5310 Buena Park Rd
Waterford, WI 53185-2907 - Phone
- (262) 534-4864
- Fax
- (262) 546-0801
- NPI assigned
- Dec 23, 2010
- Last updated
- Dec 23, 2010
- 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
- Mr. Chris Cutler
- Title
- Cfo
- Phone
- (618) 457-4729
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | 0013091 | WI | Primary |
Addresses
Primary practice location
5310 Buena Park Rd
Waterford, WI 53185-2907
Mailing address
10150 Highland Manor Dr Ste 140
Tampa, FL 33610-9712
Phone (813) 626-1444
Other names 1
- NeuroRestorative Wisconsin
National Provider Directory
National Provider Directory- Tax ID family
- Mentor Abi LLC Dba Neurorestorative Indiana
Other organizations with this tax ID 36
Organizations that report the same tax identification number in the National Provider Directory.
-
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 Maine
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Sebago, ME
- NPI 1033426739
-
dba NeuroRestorative San Antonio
- Rehabilitation Hospital
- Castle Hills, TX
- NPI 1043581937
-
- Rehabilitation Hospital
- Westerville, OH
- NPI 1144544289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293062400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1293062400000",
"number": "1649574252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10150 HIGHLAND MANOR DR STE 140",
"city": "TAMPA",
"state": "FL",
"postal_code": "336109712",
"telephone_number": "813-626-1444",
"fax_number": "813-902-6719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5310 BUENA PARK RD",
"city": "WATERFORD",
"state": "WI",
"postal_code": "531852907",
"telephone_number": "262-534-4864",
"fax_number": "262-546-0801"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MENTOR ABI",
"organizational_subpart": "NO",
"enumeration_date": "2010-12-23",
"last_updated": "2010-12-23",
"status": "A",
"authorized_official_last_name": "CUTLER",
"authorized_official_first_name": "CHRIS",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "618-457-4729",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "WI",
"license": "0013091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "NeuroRestorative Wisconsin",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Waterford, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.