Healthcare Provider Details

I. General information

NPI: 1952507782
Provider Name (Legal Business Name): GENERATIONS BEHAVIORAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 04/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10425 PLAZA AMERICANA DR
BATON ROUGE LA
70816-8188
US

IV. Provider business mailing address

9938 AIRLINE HWY SUITE 200
BATON ROUGE LA
70816-8100
US

V. Phone/Fax

Practice location:
  • Phone: 225-810-4719
  • Fax: 225-810-4722
Mailing address:
  • Phone: 225-810-4040
  • Fax: 225-810-4050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. PHILLIP S WENDELL
Title or Position: CEO
Credential:
Phone: 225-810-4040