Basic Information
| Provider Information | |||||||||
| NPI: | 1639357429 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SBH-WILMINGTON LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CAROLINA DUNES BEHAVIORAL HEALTH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8275 TOURNAMENT DR | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381258899 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9019693100 | ||||||||
| FaxNumber: | 9019693120 | ||||||||
| Practice Location | |||||||||
| Address1: | 2050 MERCANTILE DRIVE | ||||||||
| Address2: | |||||||||
| City: | LELAND | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103712500 | ||||||||
| FaxNumber: | 9103712508 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2008 | ||||||||
| LastUpdateDate: | 01/30/2022 | ||||||||
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| AuthorizedOfficialLastName: | SCHWIEGER | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
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| AuthorizedOfficialTitleorPosition: | GENERAL COUNSEL AND CCO | ||||||||
| AuthorizedOfficialTelephone: | 6157164924 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 323P00000X | N | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | 283Q00000X | Y | Hospitals | Psychiatric Hospital |
No ID Information.