Organization
KIDSPEACE CHILDREN'S HOSPITAL, INC.
Active
Parent organization
KIDSPEACE CHILDREN'S HOSPITAL, INC.
Other names
KidsPeace Outpatient Mental Health Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
KIDSPEACE CHILDREN'S HOSPITAL, INC.
Authorized official
MR. MICHAEL W SLACK (CHIEF OPERATING OFFICER)
(610) 799-8525
Entity
Organization
Contact information
Practice address
451 W. CHEW ST., SUITE 105, ALLENTOWN, PA 18102
(610) 776-5465
(610) 663-3270
Mailing address
KIDSPEACE CORPORATION, 4085 INDEPENDENCE DR, SCHNECKSVILLE, PA 18078
(610) 799-8525
(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
—
1007283700027
—
PA
Enumeration date
12/12/2014
Last updated
03/06/2019
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