Provider First Line Business Practice Location Address:
518 N ELM ST
Provider Second Line Business Practice Location Address:
SANCTUARY HOUSE INC
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27401-2018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-275-7596
Provider Business Practice Location Address Fax Number:
336-346-1748
Provider Enumeration Date:
02/18/2009