Healthcare Provider Details

I. General information

NPI: 1508794058
Provider Name (Legal Business Name): KIDSPEACE CHILDREN'S HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 HAAK ST
READING PA
19602-2214
US

IV. Provider business mailing address

4085 INDEPENDENCE DR
SCHNECKSVILLE PA
18078-2574
US

V. Phone/Fax

Practice location:
  • Phone: 610-799-7868
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SLACK
Title or Position: PRESIDENT & CEO
Credential:
Phone: 610-799-8405