Organization
SEASONS OF HOPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HEATH JACOB SOMMER PH.D. (CEO)
(208) 237-9833
Entity
Organization
Contact information
Practice address
4650 HAWTHORNE RD STE 3B, CHUBBUCK, ID 83202-2376
(208) 237-9833
(208) 237-1800
Mailing address
4650 HAWTHORNE RD STE 3B, CHUBBUCK, ID 83202-2376
(208) 237-9833
(208) 237-1800
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
PSY202423
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376865006
—
ID
Enumeration date
12/14/2010
Last updated
12/14/2010
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