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)
(610) 799-8405
Entity
Organization
Contact information
Practice address
16 KIDSPEACE WAY, GRAHAM LAKE CAMPUS, ELLSWORTH, ME 04605
(207) 771-5700
(207) 667-7169
Mailing address
4085 INDEPENDENCE DRIVE, SCHNECKSVILLE, PA 18078
(610) 799-8543
(610) 799-8318
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
216402
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123430017
—
ME
Enumeration date
12/05/2007
Last updated
07/18/2008
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