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KIDSPEACE NATIONAL CENTER INC NPI 1912042300


NPI Information

NPI: 1912042300
Provider Name: KIDSPEACE NATIONAL CENTER, INC
Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
500 N CENTRE STREET SUITE 104
POTTSVILLE, PA
ZIP 17901
Phone: (570) 516-9987
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KIDSPEACE NATIONAL CENTER, INC is an adolescent and children mental health clinic center in Pottsville, PA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. KIDSPEACE NATIONAL CENTER, INC NPI is 1912042300. The provider is registered as an organization entity type.

The provider's business location address is:

500 N CENTRE STREET SUITE 104
POTTSVILLE, PA
ZIP 17901
Phone: (570) 516-9987
Fax: (570) 581-5103

The provider's authorized official is Michael W Slack .
The authorized official title is Coo and has the following contact phone number (610) 799-8405.

The enumeration date for this NPI number is 2/21/2007 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1253J00000XFoster Care Agency222190PENNSYLVANIANo
2253J00000XFoster Care Agency206200PENNSYLVANIANo
3253J00000XFoster Care Agency206180PENNSYLVANIANo
4253J00000XFoster Care Agency206210PENNSYLVANIANo
5261QM0855XClinic/CenterAdolescent and Children Mental Health222190PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100763290-0105MEDICAIDPENNSYLVANIA
2100763290-0096MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.