Organization
M & M THERAPEUTIC GROUP HOME, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELECIA DAVIS MODICUE CLINICAL DIRECTOR (LPC, CEO)
(318) 680-8414
Entity
Organization
Contact information
Practice address
617 TENNESSEE STREET, DELHI, LA 71232
(318) 538-0600
(318) 538-0602
Mailing address
617 TENNESSEE STREET, DELHI, LA 71232
(318) 538-0600
(318) 538-0602
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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