NPIMap

Organization Active NPI

Kidspeace National Centers Inc

  • Community/Behavioral Health Agency
  • Scranton, PA
National Provider Identifier
1215072004
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
201990 Issued in PA
Legal business name
KIDSPEACE NATIONAL CENTERS INC
Practice address
101 Pittston Ave
First Floor, Ste. 3
Scranton, PA 18505-1150
Phone
(800) 854-3123
Fax
(610) 799-9318
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Callan
Title
Cfo
Phone
(610) 799-7517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 201990 PA Primary

Addresses

Primary practice location

101 Pittston Ave
First Floor, Ste. 3
Scranton, PA 18505-1150

Mailing address

4085 Independence Dr
Schnecksville, PA 18078
Phone (800) 854-3123

Other identifiers 1

IdentifierTypeStateIssuer
100763290-0026MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Kidspeace National Centers of Pennsylvania Inc47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1215072004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4085 INDEPENDENCE DR",
            "city": "SCHNECKSVILLE",
            "state": "PA",
            "postal_code": "18078",
            "telephone_number": "800-854-3123",
            "fax_number": "610-799-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PITTSTON AVE",
            "address_2": "FIRST FLOOR, STE. 3",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185051150",
            "telephone_number": "800-854-3123",
            "fax_number": "610-799-9318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSPEACE NATIONAL CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CALLAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "610-799-7517"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "201990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100763290-0026",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.