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Organization

KIDSPEACE NATIONAL CENTER, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL W SLACK (COO)
(610) 799-8405
Entity
Organization

Contact information

Practice address
500 N CENTRE STREET SUITE 104, POTTSVILLE, PA 17901
(570) 516-9987
(570) 581-5103
Mailing address
4085 INDEPENDENCE DR, SCHNECKSVILLE, PA 18078
(800) 854-3123
(610) 799-8318

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
206180
PA
253J00000X
Foster Care Agency
206200
PA
253J00000X
Foster Care Agency
206210
PA
253J00000X
Foster Care Agency
222190
PA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
222190
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100763290-0096
PA
05
100763290-0105
PA
Enumeration date
02/21/2007
Last updated
07/21/2022
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