Provider Demographics
NPI:1124728852
Name:SANCTUARY TREATMENT CENTER PLLC
Entity type:Organization
Organization Name:SANCTUARY TREATMENT CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO & CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:QINGCHUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:602-768-6706
Mailing Address - Street 1:9017 S PECOS RD STE 4550
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6621
Mailing Address - Country:US
Mailing Address - Phone:725-225-2649
Mailing Address - Fax:325-289-6197
Practice Address - Street 1:9017 S PECOS RD STE 4550
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-6621
Practice Address - Country:US
Practice Address - Phone:602-768-6704
Practice Address - Fax:325-289-6197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty