Provider Demographics
NPI:1902381403
Name:REGIONS BEHAVIORAL HOSPITAL, LLC
Entity Type:Organization
Organization Name:REGIONS BEHAVIORAL HOSPITAL, LLC
Other - Org Name:REGIONS BEHAVIORAL HEALTH OUTPATIENT
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-408-6052
Mailing Address - Street 1:8416 CUMBERLAND PL
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6543
Mailing Address - Country:US
Mailing Address - Phone:225-408-6060
Mailing Address - Fax:
Practice Address - Street 1:8416 CUMBERLAND PL
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6543
Practice Address - Country:US
Practice Address - Phone:225-408-6060
Practice Address - Fax:225-408-7410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No251S00000XAgenciesCommunity/Behavioral Health
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2700286Medicaid