Mentor Idaho, LLC

NPI #1376129866 in Meridian, Idaho

Provider Information

NPI Number
1376129866
Entity Type
Organization
Organization Name
Mentor Idaho, LLC
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Mar 23, 2021
Last Updated
May 26, 2021

Practice Location

Address
699 S OTTER AVE
State
Idaho
ZIP Code
83642-6144
Phone
(951) 201-5914

Authorized Official

Name
ROBIN E JACOME
Title
SR. BUSINESS DIRECTOR
Phone
(951) 201-5914

Specialties & Taxonomy Codes

Specialty
Community/Behavioral Health
Intermediate Care Facility, Intellectual Disabilities

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