| Wild Peace Integrative Wellness Pllc | |
|
2354 Wayzata Boulevard W. Suite A Long Lake MN 55356 | |
| (952) 260-8330 | |
| Not Available |
| Full Name | Wild Peace Integrative Wellness Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2354 Wayzata Boulevard W., Long Lake, Minnesota |
| Authorized Official Name and Position | Keely Heiser (ORGANIZER) |
| Authorized Official Contact | 9522608330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Peace Integrative Wellness Pllc 2354 W Wayzata Blvd Ste A Long Lake MN 55356-2602 Ph: (952) 260-8330 | Wild Peace Integrative Wellness Pllc 2354 Wayzata Boulevard W. Suite A Long Lake MN 55356 Ph: (952) 260-8330 |
| NPI Number | 1972449718 |
|---|---|
| Provider Enumeration Date | 04/24/2026 |
| Last Update Date | 06/06/2026 |
| Certification Date | 06/06/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972449718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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