Organization
HANNAH'S PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN T BATES (OWNER)
(208) 904-1112
Entity
Organization
Contact information
Practice address
240 W BURNSIDE AVE STE D, CHUBBUCK, ID 83202
(208) 904-1112
(866) 818-2688
Mailing address
240 W BURNSIDE AVE STE D, CHUBBUCK, ID 83202
(208) 904-1112
(866) 818-2688
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/23/2014
Last updated
02/03/2025
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