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Mentor Idaho, Llc
Developmental Disabilities Clinic/Center in Meridian, Idaho
NPI 1679148175

Mentor Idaho, Llc is a Developmental Disabilities Clinic/Center based in Rancho Cucamonga, ID and is specialized in Developmental Disabilities. Mentor Idaho, Llc practices in Meridian, ID. The NPI Number for Mentor Idaho, Llc is 1679148175 and holds a License No. (Idaho).

The current practice location address for Mentor Idaho, Llc is 1001 W Broadway Ave Apt A104, Meridian, ID and can be reached out via phone at 951-201-5914. You can also correspond with Mentor Idaho, Llc through the mailing address at 9166 ANAHEIM PL STE 200, RANCHO CUCAMONGA, CA - 91730-8547 (mailing address contact number: 951-201-5914).

Location: 1001 W Broadway Ave Apt A104, Meridian, ID, 91730-8547
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1679148175
Provider Name
Mentor Idaho, Llc
Credential
Provider Entity Type
Organization
Address
1001 W Broadway Ave Apt A104, Meridian, ID, 91730-8547
Phone Number
951-201-5914
Fax Number
Provider Enumeration Date
05/26/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1001 W Broadway Ave Apt A104
City
Meridian
State
Idaho
Zip
83642-3730
Phone Number
951-201-5914
Fax Number
person
Provider Business Mailing Address Details
Address
1001 W Broadway Ave Apt A104
City
Meridian
State
Idaho
Zip
83642-3730
Phone Number
951-201-5914
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
261QD1600X
License No.
()
Definition
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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