NPIMap

Organization Active NPI

Mentor Abi, LLC

  • Children's Rehabilitation Hospital
  • Benton, AR
National Provider Identifier
1841414232
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Rehabilitation HospitalTaxonomy code 283XC2000X
License
10042 Issued in AR
Legal business name
MENTOR ABI, LLC
Practice address
15000 Highway 298
Benton, AR 72019-9282
Phone
(501) 758-8799
Fax
(501) 753-8204
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Cindy Beaty
Title
Director of Reimbursement
Phone
(501) 758-8799

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Rehabilitation Hospital 283XC2000X 10042 AR Primary

Addresses

Primary practice location

15000 Highway 298
Benton, AR 72019-9282

Mailing address

280 Merrimack St Ste 600
Lawrence, MA 01843-1779
Phone (978) 655-2100

Other identifiers 2

IdentifierTypeStateIssuer
126843126MedicaidAR
181317526MedicaidAR

Other names 1

  • Timber Ridge Ranch NeuroRestorative Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mentor Abi37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Locations

15000 Highway 298
Benton, AR 72019
Phone (501) 758-8799

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550793600000",
    "number": "1841414232",
    "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": "978-655-2100"
        },
        {
            "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": "2007-04-13",
        "last_updated": "2019-02-22",
        "status": "A",
        "authorized_official_last_name": "BEATY",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "501-758-8799",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "283XC2000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital, Children",
            "state": "AR",
            "license": "10042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126843126",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181317526",
            "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

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.