# SANCTUARY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891048062
- **Authorized official:** MRS. MILDRED Q. LUJAN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (671) 475-7101

## Contact information

- **Practice address:** 406 MAIMAI ST, CHALAN PAGO, GU 96910-5669
- **Practice address phone:** (671) 475-7101
- **Mailing address:** 406 MAIMAI ST, CHALAN PAGO, GU 96910-5669
- **Mailing address phone:** (671) 475-7101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | 2696 | GU | — |
| 251S00000X | Community/Behavioral Health Agency | 2696 | GU | — |
| 252Y00000X | Early Intervention Provider Agency | 2696 | GU | — |
| 305S00000X | Point of Service | 2696 | GU | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 2696 | GU | Yes |
| 324500000X | Substance Abuse Rehabilitation Facility | 2696 | GU | — |

## Other

- **Enumeration date:** 10/24/2012
- **Last updated:** 10/24/2012