Organization
MENTOR ABI
Active
Organization
MENTOR ABI
Active
Other names
NeuroRestorative New Jersey
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS CUTLER (CFO)
(813) 626-1444
Entity
Organization
Contact information
Practice address
2000 CRAWFORD PL STE 700, MOUNT LAUREL, NJ 08054-3950
(813) 626-1444
(813) 621-0770
Mailing address
10150 HIGHLAND MANOR DR STE 140, TAMPA, FL 33610-9712
(813) 626-1444
(813) 902-6719
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
—
NJ
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0256625
—
NJ
Enumeration date
08/31/2010
Last updated
01/30/2013
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