| NPI | 1619676467 |
|---|---|
| Doing Business As | THE SANCTUARY MD |
| Entity Type | Organization |
| Authorized Contact | ELIJAH W MILLER Administrator 318-450-9281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2023-03-01 |