Provider Demographics
NPI:1851936660
Name:SANCTUARY SERVICES LLC
Entity type:Organization
Organization Name:SANCTUARY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:AZONI
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-688-1496
Mailing Address - Street 1:3300 AUBURN RD STE 208
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-4001
Mailing Address - Country:US
Mailing Address - Phone:248-688-1496
Mailing Address - Fax:
Practice Address - Street 1:3300 AUBURN RD STE 208
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-4001
Practice Address - Country:US
Practice Address - Phone:248-688-1496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty