KIDSPEACE NATIONAL CENTER, INC
Assisted Living, Mental Illness
Pottsville, Pennsylvania
Provider NPI: 1912042300
Organization Information:Organization Name: KIDSPEACE NATIONAL CENTER, INC
Practice Location:
500 N CENTRE STREET SUITE 104 POTTSVILLE, PA 17901 US
Tel: 570-516-9987 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
500 N CENTRE STREET SUITE 104 POTTSVILLE, PA 17901 US
Tel: 570-516-9987 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 253J00000X | Agencies Foster Care Agency | PA | 222190 |
N | 253J00000X | Agencies Foster Care Agency | PA | 206200 |
N | 253J00000X | Agencies Foster Care Agency | PA | 206180 |
N | 253J00000X | Agencies Foster Care Agency | PA | 206210 |
Y | 261QM0855X | Ambulatory Health Care Facilities Clinic/Center | PA | 222190 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
100763290-0096 | PA | 05 | |
100763290-0105 | PA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin