1. Home
  2. Directory
  3. Idaho
  4. Meridian
  5. Intermediate Care Facility Mentally Retarded
  6. NPI Profile

MENTOR IDAHO, LLC
NPI 1376129866
Intermediate Care Facility, Intellectual Disabilities in Meridian, ID

Active since March 23, 2021
699 S OTTER AVE, MERIDIAN, ID 83642(951) 201-5914 Get Directions Write a Review

NPPES record last updated: May 26, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 26, 2021, May 20, 2021, Apr 1, 2021 (3 updates tracked since 2021).

About Mentor Idaho, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MENTOR IDAHO, LLC (NPI 1376129866) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Meridian, Idaho and active in the NPI registry since March 2021. The organization lists Robin E Jacome, Sr. Business Director, as its authorized official.

NPPES Registry Identity

NPI1376129866
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameMENTOR IDAHO, LLC
Location Address699 S OTTER AVEMeridian, ID 83642-6144
Mailing Address9166 Anaheim Pl Ste 200Rancho Cucamonga, CA 91730-8547 · (915) 201-5914
Phone(951) 201-5914
Organization SubpartNo
Authorized OfficialRobin E JacomeSr. Business Director · (951) 201-5914
Enumeration DateMarch 23, 2021
Last NPPES UpdateMay 26, 20213 updates tracked since enumeration
NPPES CertifiedMay 26, 2021
✔ NPI 1376129866 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
699 S OTTER AVE, Meridian, ID 83642
Open in Google Maps ↗

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PREFERRED COMMUNITY HOMES, LLC
Intermediate Care Facility, Intellectual Disabilities
699 S OTTER AVE
MERIDIAN, ID 83642
Ada County (208) 288-2399

Frequently Asked Questions

What is MENTOR IDAHO, LLC's NPI number?

The NPI number assigned to this healthcare provider is 1376129866, enumerated as an "organization" on March 23, 2021.

Where is the provider located?

The provider is located at 699 S OTTER AVE MERIDIAN, ID 83642 and the phone number is (951) 201-5914.

What is the provider's specialty?

Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.