Mmo Jennings, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MMO JENNINGS, LLC

Practice address

110 Darbonne St.
Ste. E
Sulphur, LA 70663

Phone

(337) 527-7878

Fax

(337) 527-7880

NPI assigned

Nov 10, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert L Miller

Title

Ceo

Phone

(225) 293-6774

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MMO Sulphur Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1073594610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 NORTH BOULEVARD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708025724",
            "telephone_number": "225-293-6774",
            "fax_number": "225-291-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DARBONNE ST.",
            "address_2": "STE. E",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "70663",
            "telephone_number": "337-527-7878",
            "fax_number": "337-527-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMO JENNINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-293-6774",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "LA",
            "license": "11693",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1626066",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "60041",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMO Sulphur",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Breeana Miller, LVN
• Emilee Miller
• Gerald Miller, RPH
• Mathew Miller, RPH
• Tanya Michelle Mitchell, MD
• Moab LLC
• Sarah Monceaux
• Kellie Morasco, NP
• Amy Morgan
• Jasmine Mosely, LMSW

• Mental Health Clinic/Center (Including Community Mental Health Center) in Sulphur, LA
• Providers in Sulphur, LA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.