| Tall Pines Behavioral Health Llc | |
|
100 N 72nd Ave Wausau WI 54401-9042 | |
| (715) 301-0267 | |
| Not Available |
| Full Name | Tall Pines Behavioral Health Llc |
|---|---|
| Speciality | Psychologist |
| Location | 100 N 72nd Ave, Wausau, Wisconsin |
| Authorized Official Name and Position | Dakota Joseph Kaiser (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7155810155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tall Pines Behavioral Health Llc 100 N 72nd Ave Wausau WI 54401-9042 Ph: (715) 301-0267 | Tall Pines Behavioral Health Llc 100 N 72nd Ave Wausau WI 54401-9042 Ph: (715) 301-0267 |
| NPI Number | 1215519764 |
|---|---|
| Provider Enumeration Date | 04/24/2021 |
| Last Update Date | 08/09/2021 |
| Certification Date | 08/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215519764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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