NPIMap

Organization Active NPI

Kidspeace National Centers of Georgia, Inc

  • Community/Behavioral Health Agency
  • Bowdon, GA
National Provider Identifier
1275718389
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
022-672-D Issued in GA
Legal business name
KIDSPEACE NATIONAL CENTERS OF GEORGIA, INC
Practice address
101 Kidspeace Dr
Bowdon, GA 30108-3447
Phone
(770) 437-7200
Fax
(770) 258-9128
NPI assigned
Jan 8, 2008
Last updated
Sep 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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

Authorized official

Name
Mr. James Horan
Title
Evp/Cfo
Phone
(610) 799-8552

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 022-672-D GA Primary

Addresses

Primary practice location

101 Kidspeace Dr
Bowdon, GA 30108-3447

Mailing address

4085 Independence Dr
Schnecksville, PA 18078-2574
Phone (610) 799-8343

Other identifiers 1

IdentifierTypeStateIssuer
848487220AMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Kidspeace National Centers of Georgia Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

101 Kidspeace Dr
Bowdon, GA 30108
Phone (770) 437-7200

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1275718389",
    "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": "180782574",
            "telephone_number": "610-799-8343",
            "fax_number": "610-799-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 KIDSPEACE DR",
            "city": "BOWDON",
            "state": "GA",
            "postal_code": "301083447",
            "telephone_number": "770-437-7200",
            "fax_number": "770-258-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSPEACE NATIONAL CENTERS OF GEORGIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "HORAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "EVP/CFO",
        "authorized_official_telephone_number": "610-799-8552",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "022-672-D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "848487220A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowdon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; 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.