Organization
SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP SEAN WENDELL (CEO)
(225) 810-4050
Entity
Organization
Contact information
Practice address
323 EVERGREEN ST STE B, BUNKIE, LA 71322-1307
(318) 346-3143
(318) 295-4017
Mailing address
14707 PERKINS RD, BATON ROUGE, LA 70810-2216
(225) 810-4040
(225) 810-4050
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
283Q00000X
Psychiatric Hospital
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194112
MEDICARE
—
05
—
2700227
—
LA
Enumeration date
04/24/2014
Last updated
04/25/2024
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