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Organization
MENTOR ABI, LLC
Active
Organization
MENTOR ABI, LLC
Active
Parent organization
MENTOR ABI, LLC
Other names
Neurorestorative Kansas
Organization subpart
Yes
Provider details
NPI number
Legal business name
MENTOR ABI, LLC
Authorized official
SERGIO P CRUZ (CFO)
(781) 708-9444
Entity
Organization
Contact information
Practice address
4910 CORPORATE CENTRE DR STE 120, LAWRENCE, KS 66047-1002
(618) 559-5304
Mailing address
4910 CORPORATE CENTRE DR STE 120, LAWRENCE, KS 66047-1002
(618) 559-5304
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
—
NULL
103TR0400X
Rehabilitation Psychologist
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
251E00000X
Home Health Agency
Primary
—
NULL
283X00000X
Rehabilitation Hospital
—
NULL
Other
Enumeration date
05/01/2019
Last updated
04/28/2020
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