Organization
KIDSPEACE NATIONAL CENTERS OF NEW ENGLAND INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL W SLACK (VP FOR MARKETING AND BUSINESS DEVEL)
(800) 854-3123
Entity
Organization
Contact information
Practice address
444 STILLWATER AVE STE 204, BANGOR, ME 04401-3500
(207) 299-1414
(207) 947-6278
Mailing address
4085 INDEPENDENCE DRIVE, SCHENECKSVILLE, PA 18078
(800) 854-3123
(610) 799-8318
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
208541
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123430009
—
ME
Enumeration date
03/14/2007
Last updated
04/10/2009
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