1215055322 NPI number — PEOPLE INCORPORATED

Table of content: (NPI 1215055322)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215055322 NPI number — PEOPLE INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PEOPLE INCORPORATED
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PEOPLE INCORPORATED RIVERWIND & ANOKA ARMHS
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215055322
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3000 AMES CROSSING RD STE 600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAGAN
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55121-2519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-774-0011
Provider Business Mailing Address Fax Number:
651-774-0606

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2708 119TH AVE NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COON RAPIDS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55433-2912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-862-7944
Provider Business Practice Location Address Fax Number:
763-767-1077
Provider Enumeration Date:
03/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WIEDEMANN-WEST
Authorized Official First Name:
JILL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
651-774-0011

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  1022358 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 439R8PE . This is a "BCBS RIVERWIND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5069723 . This is a "UBH RIVERWIND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 113278 . This is a "HEALTHPARTNERS RIVERWIND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 527460505 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




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