Organization
MENTOR ABI, LLC
Active
Other names
NeuroRestorative Virginia
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (VICE PRES & SR ASST GENERAL COUNSEL)
(952) 836-2234
Entity
Organization
Contact information
Practice address
1510 SENECA DR, BLACKSBURG, VA 24060-2464
(540) 951-1902
(540) 951-9228
Mailing address
280 MERRIMACK ST, LAWRENCE, MA 01843-1779
(800) 743-6802
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
916
VA
Other
Enumeration date
03/29/2007
Last updated
02/02/2024
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