Organization
SANCTUM HEALTH PARTNERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB JOHNSON (PRESIDENT/COO)
(214) 298-3298
Entity
Organization
Contact information
Practice address
2121 MIDWAY RD STE 145, CARROLLTON, TX 75006-5263
(972) 851-1022
Mailing address
2121 MIDWAY RD STE 145, CARROLLTON, TX 75006-5263
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QA3000X
Augmentative Communication Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3930695
—
TX
Enumeration date
07/19/2023
Last updated
01/30/2026
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