NPI age
5 years
Enumerated 2021-03-23
● Active Type 2 · Organization
Mentor Idaho, Llc
Mentor Idaho, Llc is 1 of 58 intermediate care facility, intellectual disabilities organizations in Idaho.
Primary specialty
Intermediate Care Facility, Intellectual Disabilities
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Jacome
SR. Business Director
Last NPPES update
2021-05-26
Source: monthly bulk 2026-05
How this organization compares
Across 58 active intermediate care facility, intellectual disabilities providers in Idaho.
NPI age
5 years
↓ 14 yr below median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 19% of peers with subspecialties
NPI lifetime · 2021 → 2026
2021-03Enumerated in NPPES
2021
2026
Where they practice
Primary practice location
699 S Otter Ave
Meridian, ID 836426144
Mailing address
9166 Anaheim Pl Ste 200
Rancho Cucamonga, CA 917308547
Authorized official
Robin E Jacome
SR. Business Director
📞 9512015914
Specialties
-
Intermediate Care Facility, Intellectual Disabilities PrimaryAn intermediate care facility providing services for individuals with intellectual disabilities.
-
Community/Behavioral HealthA private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals...
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.