Healthcare Provider Details

I. General information

NPI: 1053652438
Provider Name (Legal Business Name): SBH EL PASO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2013
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 CALLE ADELANTE
ESPANOLA NM
87532-3464
US

IV. Provider business mailing address

5045 MCNUTT RD
SANTA TERESA NM
88008-9442
US

V. Phone/Fax

Practice location:
  • Phone: 575-589-6720
  • Fax:
Mailing address:
  • Phone: 575-589-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: PAUL GILBERT
Title or Position: CHIEF LEGAL OFFICER
Credential:
Phone: 615-545-5519