Organization
MENTOR ABI, LLC
Active
Other names
Timber Ridge Ranch NeuroRestorative Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (VP & SR ASST GENERAL COUNSEL)
(952) 836-2234
Entity
Organization
Contact information
Practice address
15000 HIGHWAY 298, BENTON, AR 72019-9282
(501) 758-8799
(501) 753-8204
Mailing address
280 MERRIMACK ST STE 600, LAWRENCE, MA 01843-1779
(501) 758-8799
(501) 753-8204
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
001
AR
283XC2000X
Children's Rehabilitation Hospital
10042
AR
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126843126
—
AR
05
—
131121125
—
AR
05
—
181317526
—
AR
05
—
181901125
—
AR
01
—
1Z001
BC/BS OF AR
AR
Enumeration date
08/31/2006
Last updated
03/18/2025
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