Organization
KIDSPEACE CHILDREN'S HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL W. SLACK (CHIEF OPERATING OFFICER)
(610) 799-8405
Entity
Organization
Contact information
Practice address
1151 POCONO BLVD STE 2, MOUNT POCONO, PA 18344-1033
(570) 243-8787
(570) 243-8797
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
05
—
1007283700028
—
PA
Enumeration date
05/13/2008
Last updated
03/06/2019
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