Basic Information
| Provider Information | |||||||||
| NPI: | 1225470461 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SBH RALEIGH, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3200 WATERFIELD DR | ||||||||
| Address2: | |||||||||
| City: | GARNER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275297727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198004400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3200 WATERFIELD DR | ||||||||
| Address2: | |||||||||
| City: | GARNER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275297727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198004400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2013 | ||||||||
| LastUpdateDate: | 05/20/2021 | ||||||||
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| AuthorizedOfficialLastName: | CAGLE | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9019693114 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SBH, LLC | ||||||||
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| NPICertificationDate: | 05/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | MHH0973 | NC | Y | Hospitals | Psychiatric Hospital |
No ID Information.