| Mmo Of Baton Rouge | |
|
4428 North Blvd Baton Rouge LA 70806-3917 | |
| (225) 267-6443 | |
| (225) 346-0157 |
| Full Name | Mmo Of Baton Rouge |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4428 North Blvd, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Robert L. Miller (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2252936774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmo Of Baton Rouge 728 North Blvd Baton Rouge LA 70802-5724 Ph: (225) 293-6774 | Mmo Of Baton Rouge 4428 North Blvd Baton Rouge LA 70806-3917 Ph: (225) 267-6443 |
| NPI Number | 1104901701 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 09/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104901701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2791 (Louisiana) | Primary |
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