Organization
KIDSPEACE NATIONAL CENTERS OF NORTH AMERICA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE JANY (CONTRACT SPECIALIST II)
(610) 799-8473
Entity
Organization
Contact information
Practice address
2711 BREEZEWOOD AVE FL 1, FAYETTEVILLE, NC 28303-5526
(910) 223-0949
(910) 223-9626
Mailing address
4085 INDEPENDENCE DR, SCHNECKSVILLE, PA 18078-2574
(610) 799-8473
(610) 799-8318
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5146A
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5146A
LICENSE
NC
Enumeration date
11/19/2012
Last updated
02/27/2013
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