Organization Name: | KIDSPEACE NATIONAL CENTERS, INC. |
NPI Number: | 1619303914 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VICKI DENGLER (CREDENTIALING SPECIALIST) |
Mailing Address: | 5300 Kidspeace Dr Orefield |
State: | PA US |
Postal Code: | 180692044 |
Phone Number: | 6107998000 |
Fax Number: | 6107998801 |
NPI Enumeration Date: | 09/18/2013 |
NPI Last Update Date: | 02/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |