Organization
SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC
Active
Parent organization
SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC
Other names
Beacon Behavioral Outpatient - Opelousas
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC
Authorized official
MR. PHILLIP SEAN WENDELL (CEO)
(337) 678-3611
Entity
Organization
Contact information
Practice address
5620 I 49 N SERVICE RD STE 11, OPELOUSAS, LA 70570-0780
(337) 678-3611
(337) 678-3599
Mailing address
4601 BLUEBONNET BLVD STE B, BATON ROUGE, LA 70809-9656
(225) 810-4040
(225) 810-4050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194112
MEDICARE
—
05
—
2700227
—
LA
Enumeration date
02/19/2020
Last updated
12/24/2020
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