M & M Therapeutic Group Home, LLP

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

M & M THERAPEUTIC GROUP HOME, LLP

Practice address

617 Tennessee Street
Delhi, LA 71232

Phone

(318) 538-0600

Fax

(318) 538-0602

NPI assigned

Apr 10, 2023

Organization subpart

No

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

Authorized official

Name

Felecia Davis Modicue, CLINICAL DIRECTOR

Title

LPC, Ceo

Phone

(318) 680-8414

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wanda Davis Martin

  • Professional Counselor
  • Delhi, LA
  • NPI 1205105889
  NPD

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681084800000",
    "number": "1902591514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 TENNESSEE STREET",
            "city": "DELHI",
            "state": "LA",
            "postal_code": "71232",
            "telephone_number": "318-538-0600",
            "fax_number": "318-538-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 TENNESSEE STREET",
            "city": "DELHI",
            "state": "LA",
            "postal_code": "71232",
            "telephone_number": "318-538-0600",
            "fax_number": "318-538-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M & M THERAPEUTIC GROUP HOME, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "MODICUE",
        "authorized_official_first_name": "FELECIA",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "LPC, CEO",
        "authorized_official_telephone_number": "318-680-8414",
        "authorized_official_credential": "CLINICAL DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Trahan Lively, LDN, RD
• Tonie London
• Louisiana Homecare of Delhi, LLC
• Mary Lundy
• M & M Behavioral Health Center LLC
• Stacy Mackey
• Maddi Girl LLC
• Natasha Marshall
• Wanda Davis Martin
• Cynthia Matthews

• Mental Illness Community Based Residential Treatment Facility in Delhi, LA
• Providers in Delhi, LA by specialty
• Mental Illness Community Based Residential Treatment Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.