Provider Demographics
NPI:1366920290
Name:SBT HEALTH INC
Entity type:Organization
Organization Name:SBT HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ERICH
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-813-2597
Mailing Address - Street 1:25819 JEFFERSON AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6965
Mailing Address - Country:US
Mailing Address - Phone:951-813-2597
Mailing Address - Fax:
Practice Address - Street 1:22783 MONTANYA PL
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-3495
Practice Address - Country:US
Practice Address - Phone:951-698-4823
Practice Address - Fax:951-346-3991
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SBT HEALTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-02
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility