NPIMap

Organization Active NPI

Sanctuary House

  • Community/Behavioral Health Agency
  • Greensboro, NC
National Provider Identifier
1467670752
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-0410632 Issued in NC
Legal business name
SANCTUARY HOUSE
Practice address
518 N Elm St
Greensboro, NC 27401-2018
Phone
(336) 275-7896
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Authorized official

Name
Elizabeth L Theisen
Title
Compliance and Contracts Manager
Phone
(336) 275-7896

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL-0410632 NC Primary
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

518 N Elm St
Greensboro, NC 27401-2018

Mailing address

PO Box 21141
Greensboro, NC 27420-1141
Phone (336) 275-7896

Other practice location 1

1505 W Friendly Ave
Greensboro, NC 27403-1206
Phone (336) 272-4037

Other practice location 2

411 W Fisher Ave
Greensboro, NC 27401-2039
Phone (336) 275-7896

Other identifiers 2

IdentifierTypeStateIssuer
8300937SMedicaidNC
8300937GMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Sanctuary House5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1505 W Friendly Ave
Greensboro, NC 27403
Phone (336) 272-4037

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": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1467670752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21141",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274201141",
            "telephone_number": "336-275-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012018",
            "telephone_number": "336-275-7896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 W Friendly Ave",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274031206",
            "country_code": "US",
            "telephone_number": "336-272-4037",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "411 W Fisher Ave",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274012039",
            "country_code": "US",
            "telephone_number": "336-275-7896",
            "fax_number": "336-346-1748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANCTUARY HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "THEISEN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "COMPLIANCE AND CONTRACTS MANAGER",
        "authorized_official_telephone_number": "336-275-7896"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-0410632",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300937S",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300937G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.