NPI 1376129866

Mentor Idaho, LLC

Organisation Intellectual Disabilities Intermediate Care Facility Meridian, ID

Practice location

Address: 699 S Otter Ave, Meridian, ID 83642-6144
Phone: (951) 201-5914
Mailing address: 9166 Anaheim Pl STE 200, Rancho Cucamonga, CA 91730-8547

Authorised official

Name: Robin E Jacome
Title: Sr. Business Director
Phone: (951) 201-5914

Registered specialties (2)

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X

Other Intermediate Care Facility, Intellectual Disabilities providers in Idaho →

Community/Behavioral Health Agency

Agencies Taxonomy 251S00000X

Other Community/Behavioral Health providers in Idaho →

Registry record

NPI: 1376129866
Entity type: Organization
NPI issued: 23 Mar 2021
Record last updated: 26 May 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.