Beacon Behavioral Health-Baton Rouge Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BEACON BEHAVIORAL HEALTH-BATON ROUGE INC

Practice address

422 Colonial Dr
Baton Rouge, LA 70806-6505

Phone

(225) 924-5655

Fax

(225) 924-5330

NPI assigned

Aug 17, 2005

Organization subpart

No

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

Authorized official

Name

Earl J Wilde III

Title

Chairman of the Board

Phone

(225) 810-4040

Specialties & licenses 1

Addresses

Other names 1

• Synergy Behavioral Health of Baton Rouge Inc. Former legal business name

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699767699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9938 AIRLINE HWY",
            "address_2": "SUITE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708168100",
            "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": "422 COLONIAL DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708066505",
            "telephone_number": "225-924-5655",
            "fax_number": "225-924-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON BEHAVIORAL HEALTH-BATON ROUGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILDE",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "225-810-4040",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy Behavioral Health of Baton Rouge Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Tori E Bazile
• Ashia Bazille
• BC Counseling LLC
• BCBR Facility Services, LLC
• Robert Mario Be, M.D.
• Beacon Behavioral Hospital - Baton Rouge LLC
• Beacon Behavioral Hospital LLC
• Beacon Behavioral Outpatient - Baton Rouge LLC
• Beacon for Life Assist Living
• Beacon for Life Assists Living

• Mental Health Clinic/Center (Including Community Mental Health Center) in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.