NPI 1003414970
Physiological Health Sanctuary LLC
Practice location
- Address
- 500 W Silver Spring Dr STE K200, Glendale, WI 53217-5052
- Phone
- (414) 207-4415
Authorised official
- Name
- Alexander Yundt
- Title
- Lpc
- Phone
- (414) 350-7286
Registered specialties
Community/Behavioral Health Agency
Primary
Registry record
- NPI
- 1003414970
- Entity type
- Organization
- NPI issued
- 13 Oct 2020
- Record last updated
- 28 Mar 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.