PHYSIOLOGICAL HEALTH SANCTUARY LLC NPI 1003414970

Community/Behavioral Health in Shorewood, WI

NPI 1003414970 Organization Community/Behavioral Health

About PHYSIOLOGICAL HEALTH SANCTUARY LLC

Physiological Health Sanctuary Llc is a provider established in Shorewood, Wisconsin specializing in community/behavioral health. The NPI number of Physiological Health Sanctuary Llc is 1003414970 and was assigned on October 2020. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Mr. Alexander Yundt Ms (Lpc)

NPI

1003414970

Provider NamePHYSIOLOGICAL HEALTH SANCTUARY LLC
Provider Location Address4465 N OAKLAND AVE UNIT 310 SHOREWOOD, WI 53211
Provider Mailing Address4465 N OAKLAND AVE UNIT 310 SHOREWOOD, WI 53211
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date10-13-2020
Last Update Date10-13-2020


Primary Taxonomy

Taxonomy Code251S00000X
ClassificationCommunity/Behavioral Health
TypeAgencies
Taxonomy DescriptionA private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Business Address

PHYSIOLOGICAL HEALTH SANCTUARY LLC
4465 N OAKLAND AVE UNIT 310
SHOREWOOD, WI
ZIP 53211
Phone: (414) 220-0378

Get Directions


Mailing Address

PHYSIOLOGICAL HEALTH SANCTUARY LLC
4465 N OAKLAND AVE UNIT 310
SHOREWOOD, WI
ZIP 53211
Phone: (414) 220-0378



Authorized Official

Authorized Official NameMR. ALEXANDER YUNDT MS
Authorized Official TitleLPC
Authorized Official Phone(414) 350-7286

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1255405320 IVAYLO HRISTOV LCSW
Individual
Social Worker (Clinical)4465 N OAKLAND AVE UNIT 310
SHOREWOOD, WI 53211
(530) 574-6855
1982132817MISS TAYLER SIMONE CLARK LCSW
Individual
Social Worker (Clinical)4465 N OAKLAND AVE UNIT 310
SHOREWOOD, WI 53211
(414) 775-3278
1891375432NOVA MENTAL HEALTH SERVICES, LLC
Organization
Social Worker (Clinical)4465 N OAKLAND AVE UNIT 310
SHOREWOOD, WI 53211
(414) 775-3278

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.