| Beacon Behavioral Health-jackson | |
|
5360 I 55 N Jackson MS 39211-4026 | |
| (601) 373-4507 | |
| Not Available |
| Full Name | Beacon Behavioral Health-jackson |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5360 I 55 N, Jackson, Mississippi |
| Authorized Official Name and Position | Phillip Wendell (CEO) |
| Authorized Official Contact | 2258104040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Behavioral Health-jackson 9938 Airline Highway Suite 200 Baton Rouge LA 70816 Ph: (225) 810-4040 | Beacon Behavioral Health-jackson 5360 I 55 N Jackson MS 39211-4026 Ph: (601) 373-4507 |
| NPI Number | 1194964049 |
|---|---|
| Provider Enumeration Date | 02/17/2009 |
| Last Update Date | 02/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194964049 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Mississippi) | Primary |
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