Organization
SKYBREAK THERAPY, PLLC
Active
Organization
SKYBREAK THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD A HILMO OTD, OTR/L (OWNER)
(213) 800-3096
Entity
Organization
Contact information
Practice address
10112 W OVERLAND RD, BOISE, ID 83709-1428
(208) 495-5401
(208) 445-3939
Mailing address
10112 W OVERLAND RD, BOISE, ID 83709-1428
(208) 495-5401
(208) 445-3939
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/09/2022
Last updated
02/08/2023
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