Mentor Abi
Community Based Residential Treatment Facility, Mental Illness in Waterford, WI. Organization (NPI-2).
NPI number1649574252
StatusActive
Last updated in NPPESDec 23, 2010
Details
- NPI
- 1649574252
- Entity type
- Organization (NPI-2)
- Legal business name
- Mentor Abi
- Organization subpart
- No
- Enumeration date
- Dec 23, 2010
- Last updated
- Dec 23, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | 0013091 | WI | Yes |
Other names
- Neurorestorative Wisconsin (Doing Business As)
Practice location
5310 Buena Park RdWaterford, WI 53185-2907
Phone 262-534-4864 · Fax 262-546-0801
Mailing address
10150 Highland Manor Dr Ste 140Tampa, FL 33610-9712
Phone 813-626-1444 · Fax 813-902-6719
Authorized official
Chris Cutler
Cfo
6184574729
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