Organization
KIDSPEACE CHILDRENS HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL W SLACK (COO)
(800) 854-3123
Entity
Organization
Contact information
Practice address
1620 BROADWAY, BETHLEHEM, PA 18015-3904
(610) 799-8600
(610) 867-9655
Mailing address
4085 INDEPENDENCE DR, SCHNECKSVILLE, PA 18078
(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
—
1007283700016
—
PA
05
—
1007283700026
—
PA
Enumeration date
02/22/2007
Last updated
03/06/2019
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