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General NPI Number Information
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NPI Number | 1164646188
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Entity Type | Organization
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Legal Business Name | HOPE HOUSE, INC.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3110 CLEVELAND BLVD SUITE B7
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City | CALDWELL
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State | ID
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Zip | 83605-0718
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Country | US
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Telephone | 208-459-8558
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Fax | 208-459-8588
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Provider Business Mailing Address
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Address Line | 3110 CLEVELAND BLVD SUITE B7
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City | CALDWELL
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State | ID
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Zip | 83605-0718
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Country | US
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Telephone | 208-459-8558
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Fax | 208-459-8588
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KEITH W CROFT
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Credential |
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Telephone | 208-459-8558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 3HOPE007
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License Number State | ID
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