OrganizationActive
Mentor Idaho, LLC
NPI 1376129866 · Intellectual Disabilities Intermediate Care Facility · Meridian, ID
Provider details
- NPI number
- 1376129866
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Robin Jacome, Sr. Business Director(951) 201-5914
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Community/Behavioral Health Agency251S00000X
Agencies
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
699 S Otter Ave
Meridian, ID 83642-6144
Phone: (951) 201-5914
Street-level locationGet directions
Mailing address
9166 Anaheim Pl Ste 200
Rancho Cucamonga, CA 91730-8547
Registry dates
- Enumerated
- 2021-03-23
- Last updated
- 2021-05-26
- Certified
- 2021-05-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.