Provider Demographics
NPI:1811229479
Name:PEACEMAKERS ARTS INITIATIVE INC
Entity Type:Organization
Organization Name:PEACEMAKERS ARTS INITIATIVE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:L
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 STE 203
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-2370
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:
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?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management