National Provider Identifier Database

MENTOR ABI LLC
Children


Contact Information

MENTOR ABI, LLC
15000 HIGHWAY 298
BENTON, AR72019-9282
Phone: 501-758-8799
Fax: 501-753-8204
Website:
Specialty Taxonomy Code
* Children 283XC2000X

* Indicates primary specialty

NPI Profile & details for MENTOR ABI, LLC

NPI Number 1841414232
Legal business name
LBN
MENTOR ABI, LLC
Authorized official CINDY BEATY - (DIRECTOR OF REIMBURSEMENT)
Entity Organization
Organization subpart No
Enumeration date 04/13/2007
Last updated 02/22/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • AR License #: 10042
  • AR Medicaid: 126843126
  • AR Medicaid: 181317526

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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