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Organization
SANCTUARY HOUSE
Active
Organization
SANCTUARY HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH L THEISEN (COMPLIANCE AND CONTRACTS MANAGER)
(336) 275-7896
Entity
Organization
Contact information
Practice address
518 N ELM ST, GREENSBORO, NC 27401-2018
(336) 275-7896
Mailing address
PO BOX 21141, GREENSBORO, NC 27420-1141
(336) 275-7896
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL-0410632
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300937G
—
NC
05
—
8300937S
—
NC
Enumeration date
04/23/2007
Last updated
05/13/2024
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