MENTOR IDAHO, LLC
NPI 1679148175
Clinic/Center - Developmental Disabilities in Meridian, ID

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

The NPI number for Mentor Idaho, LLC is 1679148175. It was assigned to this organization in the NPPES registry on May 26, 2021.

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

The primary specialty registered for this NPI is Clinic/Center, specializing in Developmental Disabilities, with taxonomy code 261QD1600X.

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 May 26, 2021

1001 W BROADWAY AVE APT A104, 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 16, 2026.

On this page

About Mentor Idaho, Llc NPPES

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

MENTOR IDAHO, LLC (NPI 1679148175) is a healthcare organization registered as a developmental disabilities in Meridian, Idaho and active in the NPI registry since May 2021. The organization lists Robin Jacome, Sr. Business Director, as its authorized official.

NPPES Registry Identity

NPI1679148175

Entity TypeOrganization

Primary Taxonomy261QD1600X

Legal Business NameMENTOR IDAHO, LLC

Location Address1001 W BROADWAY AVE APT A104Meridian, ID 83642-3730

Mailing Address9166 Anaheim Pl Ste 200Rancho Cucamonga, CA 91730-8547 · (951) 201-5914

Phone(951) 201-5914

Organization SubpartNo

Authorized OfficialRobin JacomeSr. Business Director · (951) 201-5914

Enumeration DateMay 26, 2021

NPPES CertifiedMay 26, 2021

✔ NPI 1679148175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Developmental DisabilitiesAmbulatory Health Care Facilities

Taxonomy Code261QD1600X

Definition

An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).

1001 W BROADWAY AVE APT A104, Meridian, ID 83642

Open in Google Maps ↗

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 1679148175. It was assigned to this organization in the NPPES registry on May 26, 2021.

Where is Mentor Idaho, LLC located?

Mentor Idaho, LLC is located at 1001 W Broadway Ave Apt A104, 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 Clinic/Center, specializing in Developmental Disabilities, with taxonomy code 261QD1600X.

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.