institution
Mmo Of Covington, Llc
Mental Health Clinic/Center (Including Community Mental Health Center) in Covington, Louisiana
NPI 1669428140

Mmo Of Covington, Llc is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Baton Rouge, LA and is specialized in Mental Health (Including Community Mental Health Center). Mmo Of Covington, Llc practices in Covington, LA. The NPI Number for Mmo Of Covington, Llc is 1669428140 and holds a License No. 194701 (Louisiana).

The current practice location address for Mmo Of Covington, Llc is 201 Greenbriar Blvd, Covington, LA and can be reached out via phone at 985-249-7780 and via fax at 985-249-7782. You can also correspond with Mmo Of Covington, Llc through the mailing address at 728 NORTH BLVD, BATON ROUGE, LA - 70802-5724 (mailing address contact number: 225-293-6774).

Location: 201 Greenbriar Blvd, Covington, LA, 70802-5724
institution
Provider Profile Details
NPI Number
1669428140
Provider Name
Mmo Of Covington, Llc
Credential
Provider Entity Type
Organization
Address
201 Greenbriar Blvd, Covington, LA, 70802-5724
Phone Number
985-249-7780
Fax Number
985-249-7782
Provider Enumeration Date
05/26/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
8303 01 LA OCCUPATIONAL LICENSE
institution
Provider Business Practice Location Address Details
Address
201 Greenbriar Blvd
City
State
Zip
70433-7236
Phone Number
985-249-7780
Fax Number
985-249-7782
person
Provider Business Mailing Address Details
Address
728 North Blvd
City
State
Zip
70802-5724
Phone Number
225-293-6774
Fax Number
225-291-9229
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
194701 (Louisiana)
Definition
Definition to come...
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