KIDSPEACE CHILDREN'S HOSPITAL, INC. (NPI# 1740688423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740688423 |
| Entity Type | Organization |
| Organization Name | KIDSPEACE CHILDREN'S HOSPITAL, INC. |
| Other Organization Name | KIDSPEACE OUTPATIENT MENTAL HEALTH CLINIC |
| Practice Address |
451 W. Chew St. Suite 105 Allentown PA 18102 |
| Mailing Address |
Kidspeace Corporation 4085 Independence Dr Schnecksville PA 18078 |
| Practice Telephone | 6107765465 |
| Practice Fax Number | 6106633270 |
| Mailing Telephone | 6107998525 |
| Mailing Fax Number | 6107998318 |
| Enumeration Date | 2014-12-12 |
| Last Update Date | 2019-03-06 |
| Authorized Official Name | MR. MICHAEL W SLACK (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 6107998525 |
| Is Organization Subpart | Y |
| Parent Organization Name | KIDSPEACE CHILDREN'S HOSPITAL, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
218750 | PA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 100728370-0016 | 05 | |
| PA | 1007283700027 | 05 |
| Other Name | Type Code |
|---|---|
| KidsPeace Outpatient Mental Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932744513 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 1430 W Allen St, Allentown, PA 18102-2146 | 2019-11-07 |
| 1447894589 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 137 N 2nd St, Allentown, PA 18101-1935 | 2019-11-01 |
| 1972147023 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 709 W Emaus Ave, Allentown, PA 18103-6778 | 2019-11-01 |
| 1396218871 | Kidspeace Children's Hospital, Inc. | Psychiatric Hospital | 451 Chew St Ste 105, Allentown, PA 18102-3412 | 2019-01-07 |
| 1598932261 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 1151 Pocono Blvd Ste 2, Mount Pocono, PA 18344-1033 | 2008-05-13 |
| 1811032501 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 1620 Broadway, Bethlehem, PA 18015-3904 | 2007-02-20 |
| 1740824978 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 829 W Turner St, Allentown, PA 18102-4066 | 2019-10-31 |
| 1851864979 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 1151 Pocono Blvd Ste 2, Mount Pocono, PA 18344-1033 | 2019-01-11 |
| 1225559552 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 1650 Broadway, Bethlehem, PA 18015-3904 | 2017-06-27 |
| 1083048920 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 704 Hay Rd, Temple, PA 19560-1843 | 2013-08-28 |
| Street Address |
451 W. CHEW ST. SUITE 105 |
| City | ALLENTOWN |
| State | PA |
| Zip Code | 18102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548808363 | Katherine Camoni | Counselor | 451 West Chew St., Allentwon, PA 18102 | 2019-12-11 |
| 1346802931 | Kelly Alexander | Counselor | 451 W . Chew Street, Allentown, PA 18102 | 2019-07-03 |
| 1457910481 | Ayza Taimur | Internal Medicine | 1627 West Chew Street, 101, Allentown, PA 18102 | 2019-06-12 |
| 1972161602 | Emily Skutnik | Internal Medicine | Lvpp 1627 West Chew Street #101, Allentown, PA 18102 | 2019-05-29 |
| 1508336652 | Mercy A Gonzalez Devillacis | Counselor | 843 N . 6 Th St, Allentown, PA 18102 | 2018-12-03 |
| 1134611742 | Amanda Catherine Koziel | Family Medicine | 218 N. 2nd Street, Allentown, PA 18102 | 2018-05-31 |
| 1174981369 | Marcos Morales | Counselor | 462 W. Walnut Street, Allentown, PA 18102 | 2016-02-03 |
| 1982006250 | Martha Lebron | Nurse Practitioner | 451 Chew St Ste 400, Allentown, PA 18102 | 2014-09-18 |
| 1841699741 | Nicole Tennant | Physical Therapy Assistant | 613 W Allen St, Allentown, PA 18102 | 2014-08-15 |
| 1912252461 | Lakshmi Kannan | Internal Medicine | 325 5th Street, Sacred Heart Healthcare System, Allentown, PA 18102 | 2012-07-20 |
| Find all providers in zip 18102 | ||||
| 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 |
|---|---|---|---|---|
| 1932744513 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 1430 W Allen St, Allentown, PA 18102-2146 | 2019-11-07 |
| 1447894589 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 137 N 2nd St, Allentown, PA 18101-1935 | 2019-11-01 |
| 1972147023 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 709 W Emaus Ave, Allentown, PA 18103-6778 | 2019-11-01 |
| 1942745138 | Pyramid Healthcare Inc | Clinic/Center | 106 N 17th St, Allentown, PA 18104-5673 | 2016-12-27 |
| 1639614142 | Pyramid Healthcare Inc. | Clinic/Center | 401 W Allen St, Allentown, PA 18102-2458 | 2016-12-20 |
| 1699847392 | Pinebrook Services for Children and Youth | Clinic/Center | 402 N Fulton St, Allentown, PA 18102-2002 | 2006-11-15 |
| 1740824978 | Kidspeace Children's Hospital, Inc. | Clinic/Center | 829 W Turner St, Allentown, PA 18102-4066 | 2019-10-31 |
| 1285276865 | Lehigh Valley Physician Group | Clinic/Center | 401 N 17th St Ste 203, Allentown, PA 18104-5050 | 2019-10-15 |
| 1588109771 | Pyramid Helathcare Inc. | Clinic/Center | 517 N 15th St, Allentown, PA 18102-2103 | 2016-12-27 |
| 1770028292 | Pyramid Healthcare Inc | Clinic/Center | 815 N Irving St, Allentown, PA 18109-1832 | 2016-12-20 |
| Find all providers in ALLENTOWN | ||||
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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.