Provider Demographics
NPI:1679748271
Name:PEOPLE FIRST
Entity Type:Organization
Organization Name:PEOPLE FIRST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF COTA
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:KEDZIE
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:262-895-2322
Mailing Address - Street 1:677 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-1639
Mailing Address - Country:US
Mailing Address - Phone:262-763-9531
Mailing Address - Fax:
Practice Address - Street 1:677 E STATE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-1639
Practice Address - Country:US
Practice Address - Phone:262-763-9531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40733500Medicaid