NPIMap

Organization Active NPI

San Antonio Behavioral Healthcare Hospital, LLC

  • Psychiatric Hospital
  • San Antonio, TX
National Provider Identifier
1871917971
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
00000000 Issued in TX
Legal business name
SAN ANTONIO BEHAVIORAL HEALTHCARE HOSPITAL, LLC
Practice address
8550 Huebner Rd
San Antonio, TX 78240-1803
Phone
(248) 905-5091
NPI assigned
Feb 10, 2014
Last updated
Nov 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Peter Blair Stam
Title
Executive Vice President
Phone
(951) 520-4185

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 00000000 TX Primary

Addresses

Primary practice location

8550 Huebner Rd
San Antonio, TX 78240-1803

Mailing address

8550 Huebner Rd
San Antonio, TX 78240-1803

Other identifiers 1

IdentifierTypeStateIssuer
3490591-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140619001629 TX Part A Provider - Hospital 0042434714 Practice locations: San Antonio, TX

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1871917971. Details of each certification follow.

Hospital certification: CCN 454132

Legal name
SAN ANTONIO BEHAVIORAL HEALTHCARE HOSPITAL LLC
Doing business as
AURORA BEHAVIORAL HEALTHCARE HOSPITAL - SAN ANTONIO LLC
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jan 22, 2015
Last certification
Apr 17, 2021
Beds
198
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Sep 26, 2012 in TX
Enrollment address
8550 Huebner Road
San Antonio, TX 78240-1803
Other Hospital Practice Location
Hospital subgroups
Psychiatric

Hospital certification: CCN 454037

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COVENANT BEHAVIORAL HEALTH
Certification status
Terminated Voluntary: merger or closure, Oct 11, 2000
Provider type (POS)
Hospital – Psychiatric
Participating since
Oct 21, 1985
Last certification
Feb 3, 1993
Beds
106
Ownership / control type
Private (for profit)
Most recent change of ownership
Jul 1, 1999 (2 total)
Facility address
8550 Huebner Road
San Antonio, TX 78240

Care Compare: Hospital

Medicare Care Compare
Listed as
San Antonio Behavioral Healthcare HospitalCCN 454132 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2077609San Antonio Behavioral Healthcare Hospital8550 Huebner Road, San Antonio, TX 78240Certificate of waiverMay 11, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Signature Healthcare Services, LLC Organization, Troy, MI LLC, Management services company, For-profit 5% Or Greater Direct Ownership Interest Sep 26, 2012 100%
Karen Sparrow Individual Corporate OfficerCfo Nov 1, 2021 50%
W-2 Managing EmployeeCfo Nov 1, 2021 50%
Operational/Managerial ControlCfo Nov 1, 2021 50%
Aleen Davis Arabit Individual Corporate OfficerCeo Dec 6, 2017 100%
Operational/Managerial ControlCeo Dec 6, 2017 100%
Soon Kim Individual 5% Or Greater Indirect Ownership InterestManagerial Sep 26, 2012 80%

Facilities with the same owner 16

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 16

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1871917971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 HUEBNER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 HUEBNER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401803",
            "telephone_number": "248-905-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO BEHAVIORAL HEALTHCARE HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-10",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "STAM",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "BLAIR",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "951-520-4185"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "TX",
            "license": "00000000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3490591-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.