Mentor Abi

NPI #1649574252 in Waterford, Wisconsin

Provider Information

NPI Number: 1649574252
Entity Type: Organization
Organization Name: Mentor Abi
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Dec 23, 2010
Last Updated: Dec 23, 2010

Practice Location

Address: 5310 BUENA PARK RD
City: Waterford
State: Wisconsin
ZIP Code: 53185-2907
Phone: (262) 534-4864

Authorized Official

Name: MR. CHRIS CUTLER
Title: CFO
Phone: (618) 457-4729

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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