Provider Demographics
NPI:1073822656
Name:APPLIED BEHAVIORAL INTERVENTION SERVICES, LLC
Entity Type:Organization
Organization Name:APPLIED BEHAVIORAL INTERVENTION SERVICES, LLC
Other - Org Name:ABIS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/LEAD THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KLATT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D, LBA
Authorized Official - Phone:715-852-0112
Mailing Address - Street 1:2028 HIGH POINT DR
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:WI
Mailing Address - Zip Code:54720-3506
Mailing Address - Country:US
Mailing Address - Phone:715-852-0112
Mailing Address - Fax:715-852-0112
Practice Address - Street 1:2028 HIGH POINT DR
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:WI
Practice Address - Zip Code:54720-3506
Practice Address - Country:US
Practice Address - Phone:715-852-0112
Practice Address - Fax:715-852-0112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5-140251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health