Provider Demographics
NPI:1144544289
Name:MENTOR ABI, LLC
Entity type:Organization
Organization Name:MENTOR ABI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-457-4729
Mailing Address - Street 1:PO BOX 2825
Mailing Address - Street 2:306 W MILL ST
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62902-2825
Mailing Address - Country:US
Mailing Address - Phone:618-529-3060
Mailing Address - Fax:618-529-2983
Practice Address - Street 1:6800 SUNBURY RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8214
Practice Address - Country:US
Practice Address - Phone:614-000-0000
Practice Address - Fax:614-000-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital