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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	283Q00000X	Psychiatric Hospital

General Provider Information

NPI Number	:	1881531929
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	:	888-727-4770
Fax Number	:

Provider Business Practice Location Address
First Line	:	414 S JEFFERSON ST
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54301-4113
Country	:	US
Telephone Number	:	888-379-5539
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	BRIAN J WALTON
Credential	:
Telephone Number	:	281-303-6739

Provider Enumeration Date	:	04/29/2026
Last Update Date	:	04/29/2026

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Directions to “SBH-GREEN BAY LLC ” Practice Location

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