Provider Demographics
NPI:1558507384
Name:PEACEMAKER SOCIAL SERVICES
Entity Type:Organization
Organization Name:PEACEMAKER SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLAMY II
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-562-9975
Mailing Address - Street 1:2821 N 4TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-2362
Mailing Address - Country:US
Mailing Address - Phone:414-562-9975
Mailing Address - Fax:
Practice Address - Street 1:2821 N 4TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-2362
Practice Address - Country:US
Practice Address - Phone:414-562-9975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BELLAMY ENTERPRISES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management