Organization
BEACON BEHAVIORAL HEALTH-JACKSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP WENDELL (CEO)
(225) 810-4040
Entity
Organization
Contact information
Practice address
5360 I 55 N, JACKSON, MS 39211-4026
(601) 373-4507
Mailing address
9938 AIRLINE HIGHWAY, SUITE 200, BATON ROUGE, LA 70816
(225) 810-4040
(225) 810-4050
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
MS
Other
Enumeration date
02/17/2009
Last updated
02/17/2009
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