Provider Demographics
NPI:1861667321
Name:PEOPLEFIRST REHAB
Entity Type:Organization
Organization Name:PEOPLEFIRST REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PTA
Authorized Official - Prefix:
Authorized Official - First Name:CRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERKHOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-725-2714
Mailing Address - Street 1:125 BYRD AVE
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-4015
Mailing Address - Country:US
Mailing Address - Phone:920-725-2714
Mailing Address - Fax:
Practice Address - Street 1:125 BYRD AVE
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-4015
Practice Address - Country:US
Practice Address - Phone:920-725-2714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40278000Medicaid