Provider Demographics
NPI:1215055322
Name:PEOPLE INCORPORATED
Entity type:Organization
Organization Name:PEOPLE INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:A
Authorized Official - Last Name:WIEDEMANN-WEST
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:651-774-0011
Mailing Address - Street 1:3000 AMES CROSSING RD STE 600
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-2519
Mailing Address - Country:US
Mailing Address - Phone:651-774-0011
Mailing Address - Fax:651-774-0606
Practice Address - Street 1:2708 119TH AVE NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2912
Practice Address - Country:US
Practice Address - Phone:763-862-7944
Practice Address - Fax:763-767-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1022358251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
439R8PEOtherBCBS RIVERWIND
5069723OtherUBH RIVERWIND
113278OtherHEALTHPARTNERS RIVERWIND
MN527460505Medicaid