The Sanctuary Centre

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

THE SANCTUARY CENTRE

Practice address

13420 Michael Lynn Rd
Charlotte, NC 28278-7640

Phone

(219) 730-3976

NPI assigned

Jan 30, 2020

Organization subpart

Yes

Parent organization

ONE ACCORD GLOBALAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Theodore Gilbert Jr., LCSWNPI 1588869184

Title

Clinical Director

Phone

(219) 730-3976

Specialties & licenses 1

Addresses

Part of

The Sanctuary Centre

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theodore Gilbert Jr.

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1588869184
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580774400000",
    "number": "1104457951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 663",
            "city": "PINEVILLE",
            "state": "NC",
            "postal_code": "281340663",
            "telephone_number": "219-730-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13420 MICHAEL LYNN RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787640",
            "telephone_number": "219-730-3976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SANCTUARY CENTRE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ONE ACCORD GLOBAL",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "219-730-3976",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.