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NPI Code Detail

MEDICARE: GENERATIONS BEHAVIORAL HEALTH, INC.

MEDICARE: GENERATIONS BEHAVIORAL HEALTH, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2194713OTHERLAMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952507782
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENERATIONS BEHAVIORAL HEALTH, INC.
Provider Business Mailing Address
First Line : 9938 AIRLINE HWY
Second Line : SUITE 200
City : BATON ROUGE
State : LA
Zip : 70816-8100
Country : US
Telephone Number : 225-810-4040
Fax Number : 225-810-4050
Provider Business Practice Location Address
First Line : 10425 PLAZA AMERICANA DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-8188
Country : US
Telephone Number : 225-810-4719
Fax Number : 225-810-4722
Authorized Official
Title or Position : CEO
Name : MR. PHILLIP S WENDELL
Credential :
Telephone Number : 225-810-4040
Provider Enumeration Date : 06/27/2007
Last Update Date : 04/16/2010

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