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

Q: What is Mentor Idaho, LLC's NPI number?

The NPI number for Mentor Idaho, LLC is 1376129866. It was assigned to this organization in the NPPES registry on March 23, 2021.

Q: What is Mentor Idaho, LLC's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Q: When was this NPI record last updated?

The NPPES record for Mentor Idaho, LLC was last updated on May 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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: August 09, 2026.

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

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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

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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 NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mentor Idaho, LLC's NPI number?

The NPI number for Mentor Idaho, LLC is 1376129866. It was assigned to this organization in the NPPES registry on March 23, 2021.

Where is Mentor Idaho, LLC located?

Mentor Idaho, LLC is located at 699 S Otter Ave, Meridian, ID 83642. The listed phone number is (951) 201-5914.

What is Mentor Idaho, LLC's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Mentor Idaho, LLC was last updated on May 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.