Provider Demographics
NPI:1013258011
Name:SANCTUARY INCORPORATED
Entity Type:Organization
Organization Name:SANCTUARY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAFAYAT
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSBAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-905-1155
Mailing Address - Street 1:1401 D ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1401 D ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2313
Practice Address - Country:US
Practice Address - Phone:202-905-1155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities