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Organization
BEACON BEHAVIORAL HEALTH NORTHSHORE INC
Active
Organization
BEACON BEHAVIORAL HEALTH NORTHSHORE INC
Active
Other names
Crescent Community Care Inc
Organization subpart
No
Provider details
NPI number
Authorized official
EARL J WILDE III (CHAIRMAN OF THE BOARD)
(225) 810-4040
Entity
Organization
Contact information
Practice address
820 ASBURY DR, MANDEVILLE, LA 70471
(985) 727-6090
(985) 727-6096
Mailing address
9938 AIRLINE HWY, SUITE 200, BATON ROUGE, LA 70816-8100
(225) 810-4040
(225) 810-4050
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/17/2005
Last updated
08/22/2020
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