BEACON BEHAVIORAL HEALTH-JACKSON (NPI# 1194964049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194964049 |
| Entity Type | Organization |
| Organization Name | BEACON BEHAVIORAL HEALTH-JACKSON |
| Practice Address |
5360 I 55 N Jackson MS 39211-4026 |
| Mailing Address |
9938 Airline Highway Suite 200 Baton Rouge LA 70816 |
| Practice Telephone | 6013734507 |
| Mailing Telephone | 2258104040 |
| Mailing Fax Number | 2258104050 |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2009-02-17 |
| Authorized Official Name | MR. PHILLIP WENDELL (CEO) |
| Authorized Official Telephone | 2258104040 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
MS | Ambulatory Health Care Facilities |
| Street Address |
5360 I 55 N |
| City | JACKSON |
| State | MS |
| Zip Code | 39211-4026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
| 1821628223 | Alice Powell Taylor | St. Dominic Weight Loss Solutions, 3800 Interstate 55 North Frontage Road Suite 102, Jackson, MS 39211 | 2020-01-24 | |
| 1356980643 | Bethany Powers | Pharmacist | 4910 Interstate 55 North Frontage Rd, Jackson, MS 39211 | 2020-01-03 |
| 1316585581 | Deborah Magoun Rosenbaum | Pharmacist | [email protected], 4910 I-55 North, Jackson, MS 39211 | 2019-12-18 |
| 1285108357 | Eric Wood | Counselor | 4623 Maurey Rd, Jackson, MS 39211 | 2019-01-11 |
| 1649758301 | Isluv Robertson | Registered Nurse | 1405 E Northside Dr, Jackson, MS 39211 | 2018-08-03 |
| 1659863066 | Jonbrighton Childs Russell | Student in an Organized Health Care Education/Training Program | 4343 Dalrymple Ct, Jackson, MS 39211 | 2018-05-31 |
| 1225557598 | Regina Ann Day | Dietitian, Registered | 3800 I 55 North Frontage Road, Jackson, MS 39211 | 2017-09-18 |
| 1023558525 | Agilitas Usa Inc | Clinic/Center | 120 District Blvd E, Suite D102, Jackson, MS 39211 | 2017-03-02 |
| Find all providers in zip 39211 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871103127 | Lupine Mental Health and Integrative Psychiatry LLC | Clinic/Center | 125 E Pearl Ave Ste 207, Jackson, WY 83001-8599 | 2020-08-02 |
| 1750908182 | Horizon Connections | Clinic/Center | 1818 Crane Ridge Dr Ste 101, Jackson, MS 39216-4912 | 2020-07-01 |
| 1295211787 | Nicole Rue, Psy.d., LLC | Clinic/Center | 1115 Maple Way Ste D, Jackson, WY 83001-8567 | 2018-07-17 |
| 1881102408 | Ava Family Services, LLC | Clinic/Center | 1910 Lakeland Dr Ste C, Jackson, MS 39216 | 2018-01-17 |
| 1033628466 | Bhg Lii, LLC | Clinic/Center | 794 Mcdonough Rd Ste 104, Jackson, GA 30233-1572 | 2017-09-28 |
| 1356732317 | Golden Gold Child Learning Center | Clinic/Center | 1155 Jackson Blvd, Jackson, MS 39204-2733 | 2015-02-12 |
| 1134366867 | Mississippi State Hospital | Clinic/Center | 350 Capers Ave, Jackson, MS 39203-2131 | 2009-01-16 |
| 1780852194 | Mcwillie Counseling & Diagnostic Services | Clinic/Center | 5202 Keele St Ste 1, Jackson, MS 39206-4355 | 2008-02-19 |
| 1689628190 | Catholic Charities of Jackson, Lenawee and Hillsdale Counties | Clinic/Center | 1522 Joy Ave, Jackson, MI 49203-1933 | 2006-05-20 |
| 1063466274 | Jackson-hillsdale Community Mental Health Board | Clinic/Center | 1200 N. West Avenue, Jackson, MI 49202 | 2006-05-20 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.