Healthcare Provider Details

I. General information

NPI: 1871974436
Provider Name (Legal Business Name): SBH - NORTH DENVER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 LARIMER PKWY
JOHNSTOWN CO
80534-8918
US

IV. Provider business mailing address

8295 TOURNAMENT DR SUITE 201
MEMPHIS TN
38125-8906
US

V. Phone/Fax

Practice location:
  • Phone: 970-461-5061
  • Fax:
Mailing address:
  • Phone: 901-969-3114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: JAMES CAGLE
Title or Position: CFO
Credential:
Phone: 901-969-3114