Healthcare Provider Details

I. General information

NPI: 1861993172
Provider Name (Legal Business Name): SBH-GREEN BAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 ONTARIO RD
GREEN BAY WI
54311-8302
US

IV. Provider business mailing address

501 CORPORATE CENTRE DR STE 600
FRANKLIN TN
37067-2784
US

V. Phone/Fax

Practice location:
  • Phone: 920-328-1220
  • Fax:
Mailing address:
  • Phone: 615-637-7128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: PAUL GILBERT
Title or Position: CHIEF LEGAL OFFICER
Credential:
Phone: 615-716-4924