Provider Demographics
NPI:1487900296
Name:SBH-RALEIGH, LLC
Entity type:Organization
Organization Name:SBH-RALEIGH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-969-3114
Mailing Address - Street 1:3200 WATERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-7727
Mailing Address - Country:US
Mailing Address - Phone:919-573-4999
Mailing Address - Fax:
Practice Address - Street 1:3200 WATERFIELD DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529
Practice Address - Country:US
Practice Address - Phone:919-573-4999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X, 323P00000X
NCMHH 0973283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No283Q00000XHospitalsPsychiatric Hospital