Provider Demographics
NPI:1952507782
Name:GENERATIONS BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:GENERATIONS BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:S
Authorized Official - Last Name:WENDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-810-4040
Mailing Address - Street 1:9938 AIRLINE HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-8100
Mailing Address - Country:US
Mailing Address - Phone:225-810-4040
Mailing Address - Fax:225-810-4050
Practice Address - Street 1:10425 PLAZA AMERICANA DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8188
Practice Address - Country:US
Practice Address - Phone:225-810-4719
Practice Address - Fax:225-810-4722
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEACON MANAGEMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-27
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1365602Medicaid
LA194713OtherMEDICARE