Healthcare Provider Details

I. General information

NPI: 1235997651
Provider Name (Legal Business Name): HOPE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 W RIVA CAPRI ST
MERIDIAN ID
83646-7162
US

IV. Provider business mailing address

5700 W RIVA CAPRI ST
MERIDIAN ID
83646-7162
US

V. Phone/Fax

Practice location:
  • Phone: 208-921-4458
  • Fax:
Mailing address:
  • Phone: 208-921-4458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TYLER ORAM
Title or Position: ADMINISTRATOR
Credential:
Phone: 208-921-4458