Healthcare Provider Details
I. General information
NPI: 1962290387
Provider Name (Legal Business Name): SANCTUARY 61
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/26/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5322 TUSCANY HILLS LN
SPRING TX
77373-2396
US
IV. Provider business mailing address
22738 CYPRESSWOOD DR # 1098
SPRING TX
77373-7121
US
V. Phone/Fax
- Phone: 713-894-4440
- Fax:
- Phone: 713-894-4440
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
REMBO
TUM
Title or Position: OWNER
Credential:
Phone: 713-894-4440