Organization
KIDSPEACE SERVICES 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
3333 WINTER LAKE ROAD, LAKELAND, FL 33803
(407) 339-7451
(407) 862-2737
Mailing address
4085 INDEPENDENCE DRIVE, SCHNECKSVILLE, PA 18078
(800) 854-3123
(610) 799-8318
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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