Beacon Behavioral Health Gulf Coast Inc

Primary specialty

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

Legal business name

BEACON BEHAVIORAL HEALTH GULF COAST INC

Practice address

12450 Shortcut Road
Suite E
Biloxi, MS 39532

Phone

(228) 392-3240

Fax

(228) 392-4957

NPI assigned

May 2, 2006

Last updated

Aug 22, 2020By 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

Earl J Wilde III

Title

Chairman of the Board

Phone

(225) 810-4040

Specialties & licenses 1

Addresses

Other names 1

• Synergy Behavioral Health Gulf Coast Inc Former legal business name

Locations

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851359780",
    "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": "12450 SHORTCUT ROAD",
            "address_2": "SUITE E",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39532",
            "telephone_number": "228-392-3240",
            "fax_number": "228-392-4957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON BEHAVIORAL HEALTH GULF COAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "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": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy Behavioral Health Gulf Coast Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Reginald Eugene Bass, M.D.
• Alice Bates
• John Howard Bauer, M.S.W.
• Bay Cove Assisted Living, LLC
• Alison Leigh Beach, CRNA
• Sharon Beasley
• Beawell Integrated Health LLC
• Della Beech
• Elizabeth Paige Beech, CRNA
• Mark Ian Beech

• Mental Health Clinic/Center (Including Community Mental Health Center) in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Mississippi

• 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.