Organization · Type 2 NPI
Mentor Abi
Mental Illness Community Based Residential Treatment Facility · Waterford, WI
NPI number
1649574252
Active
Practice location
5310 Buena Park Rd
Waterford, WI 53185-2907
Fax (262) 546-0801
Mailing address
10150 Highland Manor Dr Ste 140
Tampa, FL 33610-9712
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | 0013091 (WI) |
Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Another provider at this address
Other mental illness community based residential treatment facility providers in Waterford
About NPI 1649574252
Mentor Abi's National Provider Identifier is 1649574252, issued on Dec 23, 2010. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Waterford, WI. The record was last updated on Dec 23, 2010.