| Physiological Health Sanctuary Llc | |
|
500 W Silver Spring Dr Ste K200 Glendale WI 53217-5052 | |
| (414) 207-4415 | |
| Not Available |
| Full Name | Physiological Health Sanctuary Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 500 W Silver Spring Dr Ste K200, Glendale, Wisconsin |
| Authorized Official Name and Position | Alexander Yundt (LPC) |
| Authorized Official Contact | 4143507286 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Physiological Health Sanctuary Llc 500 W Silver Spring Dr Ste K200 Glendale WI 53217-5052 Ph: (414) 207-4415 | Physiological Health Sanctuary Llc 500 W Silver Spring Dr Ste K200 Glendale WI 53217-5052 Ph: (414) 207-4415 |
| NPI Number | 1003414970 |
|---|---|
| Provider Enumeration Date | 10/13/2020 |
| Last Update Date | 03/28/2024 |
| Certification Date | 11/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003414970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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