M.K. Place

LBN: Bannock Youth Foundation
M.K. Place is an health care organization with primary practice located at 110 South 19Th , Pocatello ID 83201. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Residential Treatment Facilities / Substance Abuse Rehabilitation Facility. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is the primary health care specialty. Bannock Youth Foundation can be contacted via phone (208) 234-4722, or through Hansen, Cindy K via phone (208) 234-4722.

Contact Information

Primary practice address
110 South 19Th Pocatello ID 83201
Phone: (208) 234-4722
Fax: (208) 234-2135
Website:
Map and Directions
Authorized official contact:
Name: Hansen, Cindy K Master of Arts (MA)
Phone: (208) 234-4722

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X

Profile Details

NPI number 1245665470
LBN Legal business name Bannock Youth Foundation
DBA Doing business as M.K. Place
Authorized official Hansen, Cindy K Master of Arts (MA)
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 6th, 2013
Last updated Sep 6th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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