Provider Demographics
NPI:1619160090
Name:SABIN BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:SABIN BEHAVIORAL HEALTH
Other - Org Name:HILLSBORO REHABILITATION CENTER, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:HUDDLESTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MCJ
Authorized Official - Phone:615-269-4990
Mailing Address - Street 1:695 PRESIDENT PL STE 202
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-5681
Mailing Address - Country:US
Mailing Address - Phone:615-269-4990
Mailing Address - Fax:615-953-9862
Practice Address - Street 1:695 PRESIDENT PL STE 202
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5681
Practice Address - Country:US
Practice Address - Phone:615-269-4990
Practice Address - Fax:615-953-9862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29101YM0800X
TN2601101YP2500X
TNP248103G00000X
TN43621041C0700X
TNLSW48941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1530000Medicaid
TN103G680376Medicare PIN