| Kidspeace National Centers Inc | |
|
1123c Old Berwick Rd Bloomsburg PA 17815-2913 | |
| (610) 799-8927 | |
| Not Available |
| Full Name | Kidspeace National Centers Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1123c Old Berwick Rd, Bloomsburg, Pennsylvania |
| Authorized Official Name and Position | Michael Callan (CFO) |
| Authorized Official Contact | 6107997517 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kidspeace National Centers Inc 4085 Independence Dr Schnecksville PA 18078 Ph: (800) 854-3123 | Kidspeace National Centers Inc 1123c Old Berwick Rd Bloomsburg PA 17815-2913 Ph: (610) 799-8927 |
| NPI Number | 1992840268 |
|---|---|
| Provider Enumeration Date | 02/21/2007 |
| Last Update Date | 05/21/2020 |
| Certification Date | 05/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992840268 | NPI | - | NPPES |
| 100763290-0026 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 201990 (Pennsylvania) | Primary |
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