Genesis Behavioral Hospital Inc

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

License

612 Issued in LA

Legal business name

GENESIS BEHAVIORAL HOSPITAL INC

Practice address

606 Latiolais Rd
Suite B
Breaux Bridge, LA 70517

Phone

(337) 237-4673

Fax

(337) 237-4674

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Mr. William J Arledge

Title

Cfo

Phone

(337) 237-4673

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Hospital certification: CCN 194089

Legal name

GENESIS BEHAVIORAL HOSPITAL INC

Certification status

Active

Provider type (POS)

Hospital – Psychiatric

Participating since

Mar 5, 2007

Last certification

Jul 28, 2021

Beds

18

Ownership / control type

Private (for profit)

Organization structure

CorporationProprietary

Incorporated

Nov 15, 2004 in LA

Enrollment address

606 Latiolais Dr
Unit a
Breaux Bridge, LA 70517-4231
Other Hospital Practice Location

Hospital subgroups

Psychiatric

Listed as

Genesis Behavioral HospitalCCN 194089 · All quality measures

Type

Psychiatric

Ownership

Proprietary

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

No

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

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

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mallory Buuck, LCSW

  • Social Worker
  • Lafayette, LA
  • NPI 1558124123
  NPD (past)
• Mhykeisha Evans-George, NP

  • Family Nurse Practitioner
  • Crowley, LA
  • NPI 1750881116
  NPD (past)
• Jace Craig Hebert, M.D.

  • Psychiatry Physician
  • New Orleans, LA
  • NPI 1730533761
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1023119989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 STEWART ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705018539",
            "telephone_number": "337-237-4673",
            "fax_number": "337-237-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 LATIOLAIS RD",
            "address_2": "SUITE B",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "70517",
            "telephone_number": "337-237-4673",
            "fax_number": "337-237-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS BEHAVIORAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "ARLEDGE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "337-237-4673",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "LA",
            "license": "612",
            "primary": true
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "LA",
            "license": "1702633",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "612",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric Hospital in Breaux Bridge, LA
• Providers in Breaux Bridge, LA by specialty
• Psychiatric Hospital in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.