Phoenix Behavioral Hospital of Eunice, LLC

Primary specialty

Rehabilitation Hospital UnitTaxonomy code 273Y00000X

Legal business name

PHOENIX BEHAVIORAL HOSPITAL OF EUNICE, LLC

Doing business as

Phoenix Behavioral Hospital

Practice address

2021 Crowley Rayne Hwy
Rayne, LA 70578

Phone

(337) 788-0091

Fax

(866) 933-1140

NPI assigned

Mar 7, 2008

Last updated

May 18, 2011By 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. James E Richardson

Title

Ceo

Phone

(318) 641-3717

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• PHOENIX BEHAVIORAL HOSPITAL Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346410172. Details of each certification follow.

• CCN 194097 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 194097

Legal name

PHOENIX BEHAVIORAL HOSPITAL

Certification status

Terminated Voluntary: merger or closure, Jan 11, 2017

Provider type (POS)

Hospital – Psychiatric

Participating since

Feb 6, 2009

Last certification

Aug 22, 2014

Beds

16

Ownership / control type

Private (for profit)

Facility address

2021 Crowley Rayne Highway
Rayne, LA 70578

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.

• Michael J Prejean, MD PSYCHIATRIST

  • Psychiatry Physician
  • Mamou, LA
  • NPI 1215087887
  NPD (past)

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305676800000",
    "number": "1346410172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4333 SHREVEPORT HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "71360",
            "telephone_number": "318-445-6470",
            "fax_number": "318-641-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 CROWLEY RAYNE HWY",
            "city": "RAYNE",
            "state": "LA",
            "postal_code": "70578",
            "telephone_number": "337-788-0091",
            "fax_number": "866-933-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX BEHAVIORAL HOSPITAL OF EUNICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2011-05-18",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-641-3717",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "LA",
            "license": null,
            "primary": true
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "LA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1704491",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHOENIX BEHAVIORAL HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel E Mouton
• Diane Navarre, LMT, NCBTMB
• Verna Olinger, RPH
• Patrick D. Briese, DDS, LLC
• Pharmaceutical Consultant Services
• Physical Therapy Clinic of Rayne, Inc.
• Chasity Danyelle Popillion, DPT
• Jami Prevost, LPC
• Rayne Family Healthcare, LLC
• Rayne Family Healthcare, LLC (Rayne Family Healthcare)

• Rehabilitation Hospital Unit in Rayne, LA
• Providers in Rayne, LA by specialty
• Rehabilitation Hospital Unit in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.