Provider Demographics
NPI:1376865006
Name:SEASONS OF HOPE
Entity Type:Organization
Organization Name:SEASONS OF HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:J
Authorized Official - Last Name:SOMMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:208-406-6227
Mailing Address - Street 1:703 BONANZA AVE
Mailing Address - Street 2:
Mailing Address - City:CHUBBUCK
Mailing Address - State:ID
Mailing Address - Zip Code:83202-2605
Mailing Address - Country:US
Mailing Address - Phone:208-406-6227
Mailing Address - Fax:
Practice Address - Street 1:703 BONANZA AVE
Practice Address - Street 2:
Practice Address - City:CHUBBUCK
Practice Address - State:ID
Practice Address - Zip Code:83202-2605
Practice Address - Country:US
Practice Address - Phone:208-406-6227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDAPPLIED FOR251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services