| Sacred Holistic Path Sanctuary Refuge Incorporated | |
|
15360 Fm 850 Tyler TX 75707-3916 | |
| (936) 645-9939 | |
| (903) 253-0466 |
| Full Name | Sacred Holistic Path Sanctuary Refuge Incorporated |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 15360 Fm 850, Tyler, Texas |
| Authorized Official Name and Position | Hobert Stanley Miller (PRESIDENT) |
| Authorized Official Contact | 9037326271 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sacred Holistic Path Sanctuary Refuge Incorporated P.o. Box 9636 Tyler TX 75711 Ph: (936) 645-9939 | Sacred Holistic Path Sanctuary Refuge Incorporated 15360 Fm 850 Tyler TX 75707-3916 Ph: (936) 645-9939 |
| NPI Number | 1235792599 |
|---|---|
| Provider Enumeration Date | 04/22/2019 |
| Last Update Date | 07/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235792599 | NPI | - | NPPES |
| 17799986 | Other | TX | PRIVATE INSURANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 251V00000X | Voluntary Or Charitable | (* (Not Available)) | Secondary |
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