OrganizationActive
Om Behavioral Health, Inc
NPI 1700753746 · Addiction Medicine (Preventive Medicine) Physician · Brookfield, WI
Provider details
- NPI number
- 1700753746
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Preventive Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Yoganand Gundamraj, President & Ceo(262) 391-7791
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
Practice location
12630 W North Ave Ste 1b
Brookfield, WI 53005-4626
Phone: (262) 646-0021
Fax: (262) 395-4061
Approximate (ZIP-level) locationGet directions
Mailing address
12630 W North Ave Ste 1b
Brookfield, WI 53005-4626
Registry dates
- Enumerated
- 2025-10-23
- Last updated
- 2025-12-01
- Certified
- 2025-12-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.