# CHILDREN'S THERAPY PLACE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902236235
- **Authorized official:** CELESTE COSTA (ACCOUNTS MANAGER)
- **Authorized official phone:** (208) 323-8888

## Contact information

- **Practice address:** 6855 W FAIRVIEW AVE, BOISE, ID 83704-8046
- **Practice address phone:** (208) 323-8888
- **Practice address fax:** (208) 323-8889
- **Mailing address:** 6855 W FAIRVIEW AVE, BOISE, ID 83704-8046
- **Mailing address phone:** (208) 323-8888
- **Mailing address fax:** (208) 323-8889

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | OT-1259 | ID | Yes |

## Other

- **Enumeration date:** 11/22/2013
- **Last updated:** 11/22/2013