Provider Demographics
NPI:1457479636
Name:PEOPLE INCORPORATED
Entity Type:Organization
Organization Name:PEOPLE INCORPORATED
Other - Org Name:PEOPLE INCORPORATED PEOPLE II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:A
Authorized Official - Last Name:WIEDEMANN-WEST
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:651-774-0011
Mailing Address - Street 1:3000 AMES CROSSING RD STE 600
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-2519
Mailing Address - Country:US
Mailing Address - Phone:651-774-0011
Mailing Address - Fax:651-774-0606
Practice Address - Street 1:1380 W MINNEHAHA PKWY
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55419-5220
Practice Address - Country:US
Practice Address - Phone:612-827-4671
Practice Address - Fax:612-827-1259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN334807315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN872545400Medicaid