Provider Demographics
NPI:1295871481
Name:PEOPLE'S PLACE II, INC.
Entity type:Organization
Organization Name:PEOPLE'S PLACE II, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:AMMON
Authorized Official - Last Name:KERSTETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-422-8033
Mailing Address - Street 1:1131 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-6418
Mailing Address - Country:US
Mailing Address - Phone:302-422-8026
Mailing Address - Fax:302-422-0701
Practice Address - Street 1:1131 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-6418
Practice Address - Country:US
Practice Address - Phone:302-422-8026
Practice Address - Fax:302-422-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000022286Medicaid
DE662463Medicare ID - Type Unspecified