# KIDSPEACE NATIONAL CENTER, INC

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

## Provider details

- **NPI number:** 1912042300
- **Authorized official:** MR. MICHAEL W SLACK (COO)
- **Authorized official phone:** (610) 799-8405

## Contact information

- **Practice address:** 500 N CENTRE STREET SUITE 104, POTTSVILLE, PA 17901
- **Practice address phone:** (570) 516-9987
- **Practice address fax:** (570) 581-5103
- **Mailing address:** 4085 INDEPENDENCE DR, SCHNECKSVILLE, PA 18078
- **Mailing address phone:** (800) 854-3123
- **Mailing address fax:** (610) 799-8318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253J00000X | Foster Care Agency | 206180 | PA | — |
| 253J00000X | Foster Care Agency | 206200 | PA | — |
| 253J00000X | Foster Care Agency | 206210 | PA | — |
| 253J00000X | Foster Care Agency | 222190 | PA | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 222190 | PA | Yes |

## Other

- **Enumeration date:** 02/21/2007
- **Last updated:** 07/21/2022