| Seasons Of Hope, Llc | |
|
4650 Hawthorne Rd Suite 3b Chubbuck ID 83202-2376 | |
| (208) 237-9833 | |
| (208) 237-1800 |
| Full Name | Seasons Of Hope, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4650 Hawthorne Rd, Chubbuck, Idaho |
| Authorized Official Name and Position | Heath Jacob Sommer (CEO) |
| Authorized Official Contact | 2082379833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Seasons Of Hope, Llc 4650 Hawthorne Rd Suite 3b Chubbuck ID 83202-2376 Ph: (208) 237-9833 | Seasons Of Hope, Llc 4650 Hawthorne Rd Suite 3b Chubbuck ID 83202-2376 Ph: (208) 237-9833 |
| NPI Number | 1316251895 |
|---|---|
| Provider Enumeration Date | 07/27/2010 |
| Last Update Date | 09/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316251895 | NPI | - | NPPES |
| 1376865006 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PSY202423 (Idaho) | Primary |
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