MMO OF COVINGTON LLC NPI 1669428140

NPI Information

NPI: 1669428140
Provider Name: MMO OF COVINGTON, LLC
Classification: Clinic/Center - 261QM0801X
Specialization: Mental Health (Including Community Mental Health Center)
Entity Type: Organization
Former Legal Business Name: NORTH LAKE COMMUNITY MENTAL HEALTH, LLC
Address: 201 GREENBRIAR BLVD
COVINGTON, LA
ZIP 70433
Phone: (985) 249-7780

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NPI Details

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	194701	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8303	OTHER	LOUISIANA	OCCUPATIONAL LICENSE
2	194701	MEDICARE ID-TYPE UNSPECIFIED	LOUISIANA	MEDICARE PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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