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
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251E00000X
Home Health Agency
Primary
—
—
283X00000X
Rehabilitation Hospital
—
—
Other
Enumeration date
05/01/2019
Last updated
04/28/2020
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