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Organization

REM IDAHO, LLC

Active
Other names
REM Idaho, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
ROBIN JACOME (SR. BUSINESS DIRECTOR)
(951) 201-5914
Entity
Organization

Contact information

Practice address
9627 W MEDALLION DR, BOISE, ID 83709-8251
(951) 201-5914
Mailing address
9166 ANAHEIM PL STE 200, RANCHO CUCAMONGA, CA 91730-8547
(951) 201-5914

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary

Other

Enumeration date
05/25/2021
Last updated
05/26/2021
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