Provider Demographics
NPI:1164669719
Name:PEOPLESERVE, LLC
Entity Type:Organization
Organization Name:PEOPLESERVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PECKENPAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:262-573-4556
Mailing Address - Street 1:N102W15002 HIDDEN POND CT
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-6103
Mailing Address - Country:US
Mailing Address - Phone:262-573-4556
Mailing Address - Fax:262-253-6907
Practice Address - Street 1:N102W15002 HIDDEN POND CT
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022-6103
Practice Address - Country:US
Practice Address - Phone:262-573-4556
Practice Address - Fax:262-253-6907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-18
Last Update Date:2009-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities