Provider Demographics
NPI:1043581937
Name:MENTOR ABI, LLC
Entity type:Organization
Organization Name:MENTOR ABI, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP & SR ASST GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:RODENBERG-ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-836-2234
Mailing Address - Street 1:280 MERRIMACK ST STE 600
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-2159
Mailing Address - Country:US
Mailing Address - Phone:978-655-2363
Mailing Address - Fax:
Practice Address - Street 1:124 S WINSTON LN
Practice Address - Street 2:
Practice Address - City:CASTLE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78213-1827
Practice Address - Country:US
Practice Address - Phone:210-979-0830
Practice Address - Fax:210-979-0842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility