MMO OF COVINGTON LLC NPI 1669428140

NPI Information

MMO OF COVINGTON, LLC is a mental health (including community mental health center) clinic center in Covington, LA. MMO OF COVINGTON, LLC NPI is 1669428140. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is North Lake Community Mental Health, Llc.

The provider's business location address is:

201 GREENBRIAR BLVD
COVINGTON, LA
ZIP 70433-236
Phone: (985) 249-7780
Fax: (985) 249-7782

The provider's authorized official is Robert L. Miller .
The authorized official title is Executive Officer and has the following contact phone number (225) 293-6774.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 7/2/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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