Organization
KIDSPEACE CHILDREN'S HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL SLACK (CHIEF OPERATING OFFICER)
(610) 799-8405
Entity
Organization
Contact information
Practice address
704 HAY RD, TEMPLE, PA 19560-1843
(800) 854-3123
(610) 799-8318
Mailing address
4085 INDEPENDENCE DR, SCHNECKSVILLE, PA 18078-2574
(800) 854-3123
(610) 799-8318
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
218750
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728370-0016
—
PA
Enumeration date
08/28/2013
Last updated
08/11/2017
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