| Organization Name: | BEACON BEHAVIORAL HOSPITAL-NORTHSHORE, INC. |
| NPI Number: | 1821484866 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILLIP SEAN WENDELL (CEO) |
| Mailing Address: | 64026 Highway 434 Suite 300 Lacombe |
| State: | LA US |
| Postal Code: | 704455412 |
| Phone Number: | 9858820226 |
| Fax Number: | 9858829853 |
| NPI Enumeration Date: | 04/07/2015 |
| NPI Last Update Date: | 04/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 283Q00000X |
| License Number: | 694 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Psychiatric Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |