Organization Active NPI

Sanctuary Treatment Center PLLC

  • Psychiatry Physician
  • Henderson, NV
National Provider Identifier
1124728852
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SANCTUARY TREATMENT CENTER PLLC
Practice address
9017 S Pecos Rd Ste 4550
Henderson, NV 89074-6621
Phone
(602) 768-6704
Fax
(325) 289-6197
NPI assigned
Mar 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Authorized official

Name
Mrs. Qingchuan Wang, CPA
Title
Coo & Cfo
Phone
(602) 768-6706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

9017 S Pecos Rd Ste 4550
Henderson, NV 89074-6621

Mailing address

9017 S Pecos Rd Ste 4550
Henderson, NV 89074-6621
Phone (725) 225-2649

National Provider Directory

National Provider Directory

Locations

9017 S Pecos Rd
Ste 4550
Henderson, NV 89074
Phone (725) 225-2649

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1124728852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9017 S PECOS RD STE 4550",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746621",
            "telephone_number": "725-225-2649",
            "fax_number": "325-289-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9017 S PECOS RD STE 4550",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746621",
            "telephone_number": "602-768-6704",
            "fax_number": "325-289-6197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY TREATMENT CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "QINGCHUAN",
        "authorized_official_title_or_position": "COO & CFO",
        "authorized_official_telephone_number": "602-768-6706",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.