Provider Demographics
NPI:1326781063
Name:PEER2PEER LLC
Entity Type:Organization
Organization Name:PEER2PEER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LUCRETIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-757-7222
Mailing Address - Street 1:2110 W COFFMAN AVE
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-3450
Mailing Address - Country:US
Mailing Address - Phone:130-775-7722
Mailing Address - Fax:
Practice Address - Street 1:2110 W COFFMAN AVE
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82604-3450
Practice Address - Country:US
Practice Address - Phone:130-775-7722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health