MENTOR ABI (NPI# 1558686576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558686576 |
| Entity Type | Organization |
| Organization Name | MENTOR ABI |
| Other Organization Name | OREGON ORCHID |
| Practice Address |
9125 Sw 55th Ave Portland OR 97219-5018 |
| Mailing Address |
10150 Highland Manor Dr Ste 140 Tampa FL 33610-9712 |
| Practice Telephone | 5032582440 |
| Practice Fax Number | 5032551042 |
| Mailing Telephone | 8136261444 |
| Mailing Fax Number | 8136210770 |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2010-04-01 |
| Authorized Official Name | MR. CHRIS CUTLER (BUSINESS DIRECTOR) |
| Authorized Official Telephone | 6184574729 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Oregon Orchid | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265908388 | Mentor Abi | Rehabilitation Hospital | 115a Leeds Point Rd, Galloway, NJ 08205-4211 | 2018-10-16 |
| 1033426739 | Mentor Abi | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 986 Sebago Rd, Sebago, ME 04029-3814 | 2010-09-02 |
| 1740596568 | Mentor Abi | Community Based Residential Treatment Facility, Mental Illness | 2000 Crawford Pl Ste 700, Mount Laurel, NJ 08054-3950 | 2010-08-31 |
| 1023338639 | Mentor Abi | Rehabilitation Hospital | 446 Sycamore Road, Pleasanton, CA 94588 | 2010-06-04 |
| 1366762296 | Mentor Abi | Rehabilitation Hospital | 6512 E Ludlow Dr, Scottsdale, AZ 85254-3311 | 2010-06-02 |
| 1386879096 | Mentor Abi | Community Based Residential Treatment Facility, Mental Illness | 6 King Rd, Chichester, NH 03258-6533 | 2009-05-26 |
| 1669592234 | Mentor Abi | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1510 Seneca Dr, Blacksburg, VA 24060-2464 | 2007-03-29 |
| 1639476617 | Mentor Abi | Day Training, Developmentally Disabled Services | 4219 S County Trl, Charlestown, RI 02813-3628 | 2011-02-28 |
| 1649574252 | Mentor Abi | Community Based Residential Treatment Facility, Mental Illness | 5310 Buena Park Rd, Waterford, WI 53185-2907 | 2010-12-23 |
| 1013236124 | Mentor Abi | Rehabilitation Hospital | 639 Granite St, Suite 215, Braintree, MA 02184-5366 | 2010-05-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Mentor ABI LLC | 313 Congress St, Boston, Massachusetts 02210 |
| System for Award Management (SAM) Entities | MENTOR ABI, LLC | 313 Congress St, Boston, MA 02210-1218 |
| Iowa Business Entities | MENTOR ABI, LLC | 313 Congress Street 5th Floor, Boston, MA 02210 |
| Oklahoma Business Registrations | MENTOR ABI, LLC | 313 Congress St 5th Fl, C/o The Mentor Network, Boston, MA 02210 |
| Indiana Business Entities | MENTOR ABI, LLC | 313 Congress St, 5th Fl, Boston, MA 02210 |
| Street Address |
9125 SW 55TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97219-5018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245830371 | Alec David Bondietti | Case Manager/Care Coordinator | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2020-10-28 |
| 1205452612 | Jade Lynn Marasco-wetzel | Technician | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2020-06-22 |
| 1801419890 | Elijah Rain Hart | Technician | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2020-05-25 |
| 1033739826 | Omar Bah | Case Manager/Care Coordinator | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2020-04-21 |
| 1467858902 | Benjamin Strobel | Adult Companion | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2014-11-11 |
| 1275939712 | Ross Nixon | Adult Companion | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2014-11-11 |
| 1629474176 | Jason Zerbel | Adult Companion | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2014-11-11 |
| 1669877023 | Krystal Castro | Adult Companion | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2014-10-28 |
| 1740685106 | Allison Lane Rotunno | Adult Companion | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2014-10-28 |
| 1770988131 | Sarah Lynn Marie Dupree | Adult Companion | 9125 Sw 55th Ave, Portland, OR 97219-5018 | 2014-10-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356958672 | Lighthouse Psychological Services, LLC | Psychologist | 630 Sw Nevada St, Ste. E, Poralnd, OR 97219 | 2020-09-30 |
| 1083130991 | Tawayne Nolen Malone Jr. | Psychologist | 0615 Sw Palatine Hill Road, Tawayne Malone - Msc 2159, Portland, OR 97219 | 2017-08-22 |
| 1548667918 | Eleven Eleven, LLC | Specialist/Technologist, Other | 6714 Sw 62nd Place, Portland, OR 97219 | 2014-12-01 |
| 1023414257 | Paul Shayne Hansen | Adult Companion | 9155 Sw 55th Avenue, Portland, OR 97219 | 2014-11-17 |
| 1154721850 | Mikhail Govshievich | Denturist | 9045 Sw Barbur Blvd. Suit 117, Portland, OR 97219 | 2014-08-29 |
| 1255749404 | Kristin Rae Paruszkiewicz | Physical Therapist | 7943 Sw Barbur Blvd #1, Portland, OR 97219 | 2014-07-31 |
| 1639436488 | Michelle Lorraine Emery | Counselor | 7912 Sw 35th, Portland, OR 97219 | 2012-04-18 |
| 1588930192 | Steve Ryan | Speech-Language Pathologist | 3315 Sw Falcon St, Portland, OR 97219 | 2012-03-28 |
| 1104145952 | Multnomah Family Care Center | Clinic/Center | 6787 Sw Capitol Hwy, Portland, OR 97219 | 2010-05-19 |
| 1740518331 | Trilbie L Patteson | Physical Therapy Assistant | 5701 Sw Multnomah Boulevard, West Hills Health and Rehab, Portland, OR 97219 | 2009-11-20 |
| Find all providers in zip 97219 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558732966 | John William Thompson | Community Based Residential Treatment Facility, Mental Illness | 5538 Ne 24th Ave, Portland, OR 97211-6206 | 2015-10-12 |
| 1679941785 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 130 Se 119th Ave, Portland, OR 97216-3704 | 2015-09-04 |
| 1346637816 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 17710 Halsey Crc, Portland, OR 97230 | 2015-04-22 |
| 1700273638 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 17700 Ne Halsey St, Portland, OR 97230-6734 | 2015-04-17 |
| 1447654504 | Cascadia Behavioral Health Care | Community Based Residential Treatment Facility, Mental Illness | 7405 Se 84th Ave, Portland, OR 97266-5840 | 2014-10-20 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1821491853 | Florence Mutie | Community Based Residential Treatment Facility, Mental Illness | 5123 Sw 62nd Ave, Portland, OR 97221-1170 | 2014-10-05 |
| 1679983381 | Janus Youth Program | Community Based Residential Treatment Facility, Mental Illness | 142 Se 160th Ave Apt 24, Portland, OR 97233-3558 | 2014-05-02 |
| 1558606384 | Renew Consulting, Inc. | Community Based Residential Treatment Facility, Mental Illness | 12810 Sw 62nd Ave, Portland, OR 97219-8034 | 2012-12-05 |
| 1841435518 | Cameron Care Powell | Community Based Residential Treatment Facility, Mental Illness | 14309 Se Powell Blvd, Portland, OR 97236 | 2008-12-10 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.