Provider Demographics
NPI:1487828182
Name:KIDSPEACE NATIONAL CENTERS OF NORTH AMERICA, INC.
Entity Type:Organization
Organization Name:KIDSPEACE NATIONAL CENTERS OF NORTH AMERICA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FOR MARKETING & BUSINESS DEVELOP
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:SLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-799-8405
Mailing Address - Street 1:4085 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:SCHNECKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18078-2574
Mailing Address - Country:US
Mailing Address - Phone:610-799-8543
Mailing Address - Fax:610-799-8318
Practice Address - Street 1:2080 SUGARLOAF PKWY STE 120-130
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-9401
Practice Address - Country:US
Practice Address - Phone:770-338-0800
Practice Address - Fax:770-338-2219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness