Springlake Behavioral Health Bunkie LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC

Practice address

5620 I 49 N Service Rd Ste 11
Opelousas, LA 70570-0780

Phone

(337) 678-3611

Fax

(337) 678-3599

NPI assigned

Feb 19, 2020

Organization subpart

Yes

Parent organization

SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLCAs reported in NPPES

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

Authorized official

Name

Mr. Phillip Sean Wendell

Title

Ceo

Phone

(337) 678-3611

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Beacon Behavioral Outpatient - Opelousas Doing business as

Tax ID family

Springlake Behavioral Health Bunkie LLC3 organizations share this tax ID, including this one

Part of

Springlake Behavioral Health Bunkie LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Springlake Behavioral Health Bunkie LLC

  • Psychiatric Hospital
  • Bunkie, LA
  • NPI 1184044430
  NPD tax ID
• Springlake Behavioral Health Bunkie LLC

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Bunkie, LA
  • NPI 1861074940
  NPD tax ID

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608768000000",
    "number": "1104459064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 BLUEBONNET BLVD STE B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708099656",
            "telephone_number": "225-810-4040",
            "fax_number": "225-810-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 I 49 N SERVICE RD STE 11",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705700780",
            "telephone_number": "337-678-3611",
            "fax_number": "337-678-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A",
        "authorized_official_last_name": "WENDELL",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "SEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-678-3611",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "194112",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2700227",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Behavioral Outpatient - Opelousas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Opelousas, LA
• Providers in Opelousas, LA by specialty
• Mental Health Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.