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● Active Type 2 · Organization

Mentor Idaho, Llc

Clinic/Center·Boise, ID· NPI 1144896515 · Enumerated 2021 · 4 years on NPI
Mentor Idaho, Llc is 1 of 40 clinic/center organizations in Idaho.
NPI age
4 years
Enumerated 2021-05-27
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Jacome
SR. Business Director
Last NPPES update
2021-05-27
Source: monthly bulk 2026-05

How this organization compares

Across 40 active clinic/center providers in Idaho.

NPI age
4 years
≈ at median (4 yr)
Practice locations
1
0 secondary on file
Subspecialties
0

NPI lifetime · 2021 → 2026

2021-05Enumerated in NPPES
2021 2026

Where they practice

Primary practice location
12553 W Explorer Dr Ste 190
Boise, ID 837131612
📞 9512015914
Mailing address
9166 Anaheim Place, Suie 200
Rancho Cucamonga, CA 91730
📞 9512015914

Authorized official

Robin E Jacome
SR. Business Director
📞 9512015914

Individual providers at this organization

20 individual providers on file at this primary practice address.

Specialties

Ambulatory Health Care Facilities › Clinic/Center
  • Clinic/Center Primary
    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...
    taxonomy 261QD1600X

Other names on file (1)

Doing-business-as, former, and alternate names recorded by NPPES.

  • Mentor Idaho, LLC
    Type code 3 recorded 2021-05-17

Practice context

Multi-provider organization. 20 individual providers on file at this primary address.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

Related

Clinic/Center organizations in Idaho
→ Idaho hub
About this specialty
→ Specialty guide