Healthcare Provider Details

I. General information

NPI: 1760437131
Provider Name (Legal Business Name): BEACON BEHAVIORAL HOSPITAL - NEW ORLEANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14500 HAYNE BLVD
NEW ORLEANS LA
70128-1751
US

IV. Provider business mailing address

14707 PERKINS RD
BATON ROUGE LA
70810-2216
US

V. Phone/Fax

Practice location:
  • Phone: 504-210-0460
  • Fax: 504-210-0970
Mailing address:
  • Phone: 225-810-4040
  • Fax: 225-810-4050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number692
License Number StateLA

VIII. Authorized Official

Name: PHILLIP SEAN WENDELL
Title or Position: CEO
Credential:
Phone: 225-810-4040