Provider Demographics
NPI:1255368619
Name:HARRISON'S HOPE, INC.
Entity type:Organization
Organization Name:HARRISON'S HOPE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS & COMPLIANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-947-6800
Mailing Address - Street 1:3137 S MERIDIAN RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-7088
Mailing Address - Country:US
Mailing Address - Phone:208-947-6800
Mailing Address - Fax:208-947-6806
Practice Address - Street 1:3137 S MERIDIAN RD
Practice Address - Street 2:SUITE 120
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-7088
Practice Address - Country:US
Practice Address - Phone:208-947-6800
Practice Address - Fax:208-947-6806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807590700OtherMEDICAID PROVIDER NUMVER
ID131553Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER