Springlake Behavioral Health Bunkie LLC

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

Legal business name

SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC

Practice address

323 Evergreen St Ste B
Bunkie, LA 71322-1307

Phone

(318) 346-3143

Fax

(318) 295-4017

NPI assigned

Apr 24, 2014

Last updated

Apr 25, 2024By the provider in NPPES

Organization subpart

No

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

(225) 810-4050

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184044430. Details of each certification follow.

• CCN 194112 Hospital · Active · Details

Hospital certification: CCN 194112

Legal name

SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC

Doing business as

BEACON BEHAVIORAL HOSPITAL-CENTRAL

Certification status

Active

Provider type (POS)

Hospital – Psychiatric

Participating since

Oct 6, 2015

Last certification

Nov 11, 2024

Beds

24

Ownership / control type

Private (for profit)

Organization structure

LLCProprietary

Incorporated

Jan 23, 2014 in LA

Enrollment address

323 Evergreen Street
Ste B
Bunkie, LA 71322-1307
Other Hospital Practice Location

Hospital subgroups

Psychiatric

Listed as

Beacon Behavioral Hospital - CentralCCN 194112 · All quality measures

Type

Psychiatric

Ownership

Proprietary

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

No

Tax ID family

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

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

  dba Beacon Behavioral Outpatient - Opelousas

  • Mental Health Counselor
  • Opelousas, LA
  • NPI 1104459064
  NPD tax ID
• Springlake Behavioral Health Bunkie LLC

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

Locations

All disclosed owners & managing parties 2

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

Facilities with the same owner 3

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

• Beacon Behavioral Hospital - New Orleans LLC

  • Psychiatric Hospital
  • New Orleans, LA
  • NPI 1760437131

  Beacon Hospital Management, LLC

  CMS ownership
• Beacon Behavioral Hospital LLC

  dba Beacon Behavioral Outpatient - Lutcher

  • Psychiatric Hospital
  • Lutcher, LA
  • NPI 1881996940

  Beacon Hospital Management, LLC

  CMS ownership
• Beacon Behavioral Hospital Northshore, LLC

  • Psychiatric Hospital
  • Lacombe, LA
  • NPI 1508819202

  Beacon Hospital Management, LLC

  CMS ownership

Practitioners 1

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.

• Nicole Dickens, MD

  • Psychiatry Physician
  • Lafayette, LA
  • NPI 1376522516
  NPD (past)

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1184044430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14707 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708102216",
            "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": "323 EVERGREEN ST STE B",
            "city": "BUNKIE",
            "state": "LA",
            "postal_code": "713221307",
            "telephone_number": "318-346-3143",
            "fax_number": "318-295-4017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Versailles Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "713033979",
            "country_code": "US",
            "telephone_number": "225-810-4040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5620 I 49 N Service Rd Ste 11",
            "address_purpose": "LOCATION",
            "city": "Opelousas",
            "state": "LA",
            "postal_code": "705700780",
            "country_code": "US",
            "telephone_number": "337-678-3611",
            "fax_number": "337-678-3599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "816 Creswell Ln Ste 2&3",
            "address_purpose": "LOCATION",
            "city": "Opelousas",
            "state": "LA",
            "postal_code": "705705805",
            "country_code": "US",
            "telephone_number": "337-678-3611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "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": "225-810-4050",
        "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": 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": []
}

• Lorita Lynette Slaughter, BCBA
• Ashley Smith
• Latoya Smith
• Anthony Bruce Soileau Jr., R.PH.
• Southern Grace Healthcare LLC
• Springlake Behavioral Health Bunkie LLC
• Mohit Srivastava, MD
• Michael John Stacey, D.D.S.
• Sylvia's Caring Companions Health Care Services
• Sylvia's Caring Companions Health Care Services

• Psychiatric Hospital in Bunkie, LA
• Providers in Bunkie, LA by specialty
• Psychiatric Hospital in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.