Healthcare Provider Details

I. General information

NPI: 1770956286
Provider Name (Legal Business Name): SBH - RALEIGH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2015
Last Update Date: 11/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 WATERFIELD DR
GARNER NC
27529-7727
US

IV. Provider business mailing address

3200 WATERFIELD DR
GARNER NC
27529-7727
US

V. Phone/Fax

Practice location:
  • Phone: 919-800-4400
  • Fax: 919-573-4163
Mailing address:
  • Phone: 919-800-4400
  • Fax: 919-573-4163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES CAGLE
Title or Position: CFO
Credential:
Phone: 901-969-3100