Provider Demographics
NPI:1164646188
Name:HOPE HOUSE, INC.
Entity Type:Organization
Organization Name:HOPE HOUSE, INC.
Other - Org Name:HOPE DEVELOPMENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:W
Authorized Official - Last Name:CROFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-459-8558
Mailing Address - Street 1:3110 CLEVELAND BLVD
Mailing Address - Street 2:SUITE B7
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83605-0718
Mailing Address - Country:US
Mailing Address - Phone:208-459-8558
Mailing Address - Fax:208-459-8588
Practice Address - Street 1:3110 CLEVELAND BLVD
Practice Address - Street 2:SUITE B7
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-0718
Practice Address - Country:US
Practice Address - Phone:208-459-8558
Practice Address - Fax:208-459-8588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID3HOPE007251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services