NPIMap

Organization Active NPI

Kidspeace Services Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Lakeland, FL
National Provider Identifier
1962693077
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
KIDSPEACE SERVICES INC
Practice address
3333 Winter Lake Road
Lakeland, FL 33803
Phone
(407) 339-7451
Fax
(407) 862-2737
NPI assigned
Aug 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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
(610) 799-8405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

3333 Winter Lake Road
Lakeland, FL 33803

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Kidspeace Services Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

3333 Winter Lake Rd
Lakeland, FL 33803
Phone (407) 339-7451

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1962693077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4085 INDEPENDENCE DRIVE",
            "city": "SCHNECKSVILLE",
            "state": "PA",
            "postal_code": "18078",
            "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": "3333 WINTER LAKE ROAD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33803",
            "telephone_number": "407-339-7451",
            "fax_number": "407-862-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSPEACE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "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": "610-799-8405",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; 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.