Jeanettes Sanctuary LLC

NPI #1710788419 in Elyria, Ohio

Provider Information

NPI Number: 1710788419
Entity Type: Organization
Organization Name: Jeanettes Sanctuary LLC
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Mar 20, 2025
Last Updated: Mar 20, 2025

Practice Location

Address: 38780 CHESTNUT RIDGE RD
City: Elyria
State: Ohio
ZIP Code: 44035-8232
Phone: (440) 219-4004

Authorized Official

Name: MRS. LATASHA MONIQUE GORDON, LPC, LICDC, OCPSA
Title: FOUNDER/CEO
Phone: (440) 657-6446

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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