Provider Demographics
NPI:1225724016
Name:SANCTUARY RECOVERY AND WELLNESS, LLC
Entity Type:Organization
Organization Name:SANCTUARY RECOVERY AND WELLNESS, LLC
Other - Org Name:SANCTUARY RECOVERY & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BURCHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-929-4244
Mailing Address - Street 1:5600 S QUEBEC ST STE 110D
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2222
Mailing Address - Country:US
Mailing Address - Phone:303-929-4244
Mailing Address - Fax:
Practice Address - Street 1:5600 S QUEBEC ST STE 110D
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2222
Practice Address - Country:US
Practice Address - Phone:303-929-4244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-13
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder