MEDICARE: SBH-GREEN BAY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1861993172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SBH-GREEN BAY LLC

Provider Business Mailing Address
First Line	:	501 CORPORATE CENTRE DR STE 600
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-2784
Country	:	US
Telephone Number	:	615-637-7128
Fax Number	:

Provider Business Practice Location Address
First Line	:	1351 ONTARIO RD
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54311-8302
Country	:	US
Telephone Number	:	920-328-1220
Fax Number	:

Authorized Official
Title or Position	:	CHIEF LEGAL OFFICER
Name	:	PAUL GILBERT
Credential	:
Telephone Number	:	615-716-4924

Provider Enumeration Date	:	02/22/2018
Last Update Date	:	10/21/2025

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Directions to “SBH-GREEN BAY LLC ” Practice Location

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