Provider Demographics
NPI:1851864979
Name:KIDSPEACE CHILDREN'S HOSPITAL, INC.
Entity Type:Organization
Organization Name:KIDSPEACE CHILDREN'S HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRAT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNSICKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-799-7331
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:610-799-7331
Mailing Address - Fax:610-799-8318
Practice Address - Street 1:1151 POCONO BLVD STE 2
Practice Address - Street 2:
Practice Address - City:MOUNT POCONO
Practice Address - State:PA
Practice Address - Zip Code:18344-1033
Practice Address - Country:US
Practice Address - Phone:570-243-8787
Practice Address - Fax:570-243-8797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health