Organization · Type 2 NPI
Mentor Idaho, LLC
Intellectual Disabilities Intermediate Care Facility · Meridian, ID
NPI number
1376129866
Active
Practice location
699 S Otter Ave
Meridian, ID 83642-6144
Mailing address
9166 Anaheim Pl Ste 200
Rancho Cucamonga, CA 91730-8547
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | None listed |
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | None listed |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
Another provider at this address
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About NPI 1376129866
Mentor Idaho, LLC's National Provider Identifier is 1376129866, issued on Mar 23, 2021. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Meridian, ID. The record was last updated on May 26, 2021.