Organization · Type 2 NPI
Mentor Idaho, LLC
Developmental Disabilities Clinic/Center · Meridian, ID
Practice location
1001 W Broadway Ave Apt A104
Meridian, ID 83642-3730
Mailing address
9166 Anaheim Pl Ste 200
Rancho Cucamonga, CA 91730-8547
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmental Disabilities Clinic/Center Primary | 261QD1600X | None listed |
Developmental Disabilities Clinic/Center: 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.).
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About NPI 1679148175
Mentor Idaho, LLC's National Provider Identifier is 1679148175, issued on May 26, 2021. The primary taxonomy on file is Developmental Disabilities Clinic/Center (261QD1600X), and the practice location is in Meridian, ID. The record was last updated on May 26, 2021.