Provider Demographics
NPI:1558075531
Name:THE SANCTUARY CARE & COUNSELING CENTER
Entity Type:Organization
Organization Name:THE SANCTUARY CARE & COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:SHANA
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:888-530-1128
Mailing Address - Street 1:2413 MAIN ST # 145
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7809
Mailing Address - Country:US
Mailing Address - Phone:888-530-1128
Mailing Address - Fax:786-408-7503
Practice Address - Street 1:397 BRIDGE STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:888-530-1128
Practice Address - Fax:786-408-7503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty