Provider Demographics
NPI:1073552444
Name:BEHAVIORAL HOSPTIAL OF BATON ROUGE
Entity Type:Organization
Organization Name:BEHAVIORAL HOSPTIAL OF BATON ROUGE
Other - Org Name:CONTINUUM HEALTHCARE MANAGEMENT
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGGERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-343-1994
Mailing Address - Street 1:4040 NORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-3829
Mailing Address - Country:US
Mailing Address - Phone:225-343-1994
Mailing Address - Fax:210-492-9160
Practice Address - Street 1:4040 NORTH BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3829
Practice Address - Country:US
Practice Address - Phone:225-434-1994
Practice Address - Fax:210-492-9160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA549283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1709999Medicaid
LA194066Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER