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Contact Information

OM BEHAVIORAL HEALTH, INC
12630 W NORTH AVE STE 1B
BROOKFIELD, WI53005-4626
 Phone: 262-646-0021
 Fax: 262-395-4061
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

2083A0300X 84 Physician/Preventive Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for OM BEHAVIORAL HEALTH, INC

NPI # 1700753746
LBN Legal business name OM BEHAVIORAL HEALTH, INC
Authorized official YOGANAND GUNDAMRAJ - (PRESIDENT & CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 10/23/2025
Last updated 12/01/2025 - About 6 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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