Sanctuary

Provider details

NPI number

1891048062

Entity type

Organization

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities

Organization subpart

No

Authorized official

Mildred Lujan, Executive Director(671) 475-7101

License

2696 (GU)

Specialties & taxonomies

• Emotionally Disturbed Childrens' Residential Treatment FacilityPrimary322D00000XLicense 2696 (GU)

  Residential Treatment Facilities

• Case Management Agency251B00000XLicense 2696 (GU)

  Agencies

• Community/Behavioral Health Agency251S00000XLicense 2696 (GU)

  Agencies

• Early Intervention Provider Agency252Y00000XLicense 2696 (GU)

  Agencies

• Point of Service305S00000XLicense 2696 (GU)

  Managed Care Organizations

• Substance Abuse Rehabilitation Facility324500000XLicense 2696 (GU)