Organization
SBH-MADISON LLC
Active
Other names
Miramont Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL GILBERT (CHIEF LEGAL OFFICER)
(615) 716-4924
Entity
Organization
Contact information
Practice address
3169 DEMING WAY, MIDDLETON, WI 53562-1435
(901) 969-3100
Mailing address
3169 DEMING WAY, MIDDLETON, WI 53562-1435
(608) 716-8288
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3340
STATE LICENSE
WI
01
—
3535
STATE LICENSE
WI
Enumeration date
10/05/2020
Last updated
03/23/2026
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