Healthcare Provider Details

I. General information

NPI: 1922556778
Provider Name (Legal Business Name): SBH-GREEN BAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2016
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
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 901-969-3100
  • Fax:
Mailing address:
  • Phone: 615-637-7128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
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: 615-716-4924