Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mentor Idaho, LLC

Organization Developmental Disabilities Clinic/Center · NPI 1144896515

Mentor Idaho, LLC is a Developmental Disabilities Clinic/Center in Boise, Idaho. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12553 W Explorer Dr Ste 190
Boise, ID 83713-1612
Phone: (951) 201-5914
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Developmental Disabilities Clinic/Center (primary) Taxonomy 261QD1600X

Record details

NPI number1144896515
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robin Jacome — Sr. Business Director · (951) 201-5914
Other names Mentor Idaho, Llc
NPI enumeratedMay 27, 2021
Last updated in NPPESMay 27, 2021
Certification dateMay 17, 2021
Mailing address9166 Anaheim Place, Suie 200, Rancho Cucamonga, CA 91730

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