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Organization
MMO JENNINGS, LLC
Active
Organization
MMO JENNINGS, LLC
Active
Other names
MMO Sulphur
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT L MILLER (CEO)
(225) 293-6774
Entity
Organization
Contact information
Practice address
110 DARBONNE ST., STE. E, SULPHUR, LA 70663
(337) 527-7878
(337) 527-7880
Mailing address
728 NORTH BOULEVARD, BATON ROUGE, LA 70802-5724
(225) 293-6774
(225) 291-9229
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
11693
LA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1626066
—
LA
01
—
60041
BLUE CROSS
—
Enumeration date
11/10/2005
Last updated
01/11/2011
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