KIDSPEACE SERVICES INC (NPI# 1629101423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629101423 |
Entity Type | Organization |
Organization Name | KIDSPEACE SERVICES INC |
Practice Address |
633 B Brevard Avenue Cocoa FL 32922 |
Mailing Address |
4085 Independence Drive Schenecksville PA 18078 |
Practice Telephone | 3216317740 |
Practice Fax Number | 3216317741 |
Mailing Telephone | 8008543123 |
Mailing Fax Number | 6107998318 |
Enumeration Date | 2007-03-13 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MR. MICHAEL W SLACK (VP FOR MARKETING AND BUSINESS DEVEL) |
Authorized Official Telephone | 8008543123 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962693077 | Kidspeace Services Inc | Clinic/Center | 3333 Winter Lake Road, Lakeland, FL 33803 | 2007-08-05 |
1255536363 | Kidspeace Services Inc | Clinic/Center | 1950 Benoist Farms Road, West Palm Beach, FL 33411 | 2007-06-19 |
1356400741 | Kidspeace Services Inc | Clinic/Center | 711 Ballard Street, Altamonte Springs, FL 32071 | 2006-12-08 |
Street Address |
633 B BREVARD AVENUE |
City | COCOA |
State | FL |
Zip Code | 32922 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396260030 | Shacarra Danielle Pouncey | Behavioral Analyst | 453 King Street, Cocoa, FL 32922 | 2017-08-03 |
1851815849 | El-shaddai & Sons Maintenance LLC | Non-emergency Medical Transport (VAN) | 209 Factory St, Cocoa, FL 32922 | 2017-08-01 |
1891241949 | Stephanie B Duncan Kidwell | Developmental Therapist | 453 Cocoa St., Cocoa, FL 32922 | 2016-08-29 |
1861859746 | Ruth Ellis | Counselor | 7 N. Cocoa Blvd., Cocoa, FL 32922 | 2016-01-22 |
1528334109 | Cynthia Vicky Doyle | Counselor | 1407 Dixon Blvd., Cocoa, FL 32922 | 2012-03-28 |
1205156106 | Rhea Lucette Gibbs | Social Worker | 317 Riveredge B Lvd., Suite 104, Cocoa, FL 32922 | 2010-06-03 |
1871816439 | Suzanne P. Jasper-demarco | Behavioral Analyst | 550 Saint Johns St, Cocoa, FL 32922 | 2010-03-10 |
1023223294 | Loraine Catalano Schuh | Social Worker | 317 Riveredge Blvd, Suite 104, Cocoa, FL 32922 | 2007-05-11 |
1679795546 | Amber Elizabeth Bell | Counselor | Kidspeace, 633-b Brevard Avenue, Cocoa, FL 32922 | 2007-05-02 |
1154549343 | Venkata Naga Laxmi Cheedhella | Pharmacist | 1451 Dixon Blvd, Cocoa, FL 32922 | 2007-04-23 |
Find all providers in zip 32922 |
Taxonomy Code | 261QM0855X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Adolescent and Children Mental Health |
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144464124 | Pasqua Marongiu Psy D Pa | Clinic/Center | 1970 Michigan Ave, Building C-1, Cocoa, FL 32922-5758 | 2009-04-22 |
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1942769567 | Veronica Castro, Psy.d., Pa | Clinic/Center | 9380 Sunset Dr Ste B165, Miami, FL 33173-5456 | 2019-03-13 |
1780159061 | Solutions Center for Personal Growth | Clinic/Center | 664 Se Monterey Rd, Stuart, FL 34994-4410 | 2018-10-12 |
1821595281 | Inspirations Youth Academy LLC | Clinic/Center | 757 South East 17th Street, Fort Lauderdale, FL 33316-2960 | 2018-04-11 |
1558867341 | All Star Children's Foundation | Clinic/Center | 3308 17th St, Sarasota, FL 34235-8904 | 2018-04-02 |
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Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.