| Organization Name: | MMO JENNINGS, LLC |
| NPI Number: | 1073594610 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT L MILLER (CEO) |
| Mailing Address: | 110 Darbonne St. Ste. E Sulphur |
| State: | LA US |
| Postal Code: | 70663 |
| Phone Number: | 3375277878 |
| Fax Number: | 3375277880 |
| NPI Enumeration Date: | 11/10/2005 |
| NPI Last Update Date: | 01/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | 11693 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |