NPIMap

Organization Active NPI

Kidspeace National Centers Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Bethlehem, PA
National Provider Identifier
1659524395
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
201990 Issued in PA
Legal business name
KIDSPEACE NATIONAL CENTERS INC.
Practice address
1620 Broadway
Bethlehem, PA 18015-3904
Phone
(610) 799-8119
Fax
(610) 799-8197
NPI assigned
Oct 28, 2008
Last updated
Jul 21, 2022By the provider in NPPES
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
Mr. Michael W Slack
Title
VP for Marketing and Business Devel
Phone
(800) 854-3123

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 201990 PA Primary
Community/Behavioral Health Agency 251S00000X 201990 PA

Addresses

Primary practice location

1620 Broadway
Bethlehem, PA 18015-3904

Mailing address

4085 Independence Dr
Schnecksville, PA 18078-2574
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

Locations

1620 Broadway
Bethlehem, PA 18015
Phone (610) 799-8222

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1659524395",
    "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": "800-854-3123",
            "fax_number": "610-799-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 BROADWAY",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180153904",
            "telephone_number": "610-799-8119",
            "fax_number": "610-799-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSPEACE NATIONAL CENTERS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SLACK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "VP FOR MARKETING AND BUSINESS DEVEL",
        "authorized_official_telephone_number": "800-854-3123",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "PA",
            "license": "201990",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "201990",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100763290-0026",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, 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.