MEDICARE: MMO JENNINGS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center	7858	LA
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60041	OTHER		BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578554853
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MMO JENNINGS, LLC

Provider Business Mailing Address
First Line	:	619 N MAIN ST
Second Line	:
City	:	JENNINGS
State	:	LA
Zip	:	70546-5347
Country	:	US
Telephone Number	:	337-824-4300
Fax Number	:	337-824-4315

Provider Business Practice Location Address
First Line	:	728 NORTH BOULEVARD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70802-5724
Country	:	US
Telephone Number	:	225-293-6774
Fax Number	:	225-291-9229

Authorized Official
Title or Position	:	CEO
Name	:	MR. ROBERT L MILLER
Credential	:
Telephone Number	:	225-293-6774

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	01/11/2011

Similar Medicare Providers

1194940510 — FAMILY CHIROPRACTIC CLINIC
Practice Location Address:

3855 N ACADIAN THRUWAY
BATON ROUGE, LA
70805-5724

Practice Phone: 225-356-4449
Practice Fax: 225-355-3213

1780216929 — RODERICK LEE EDWARDS II
Practice Location Address:

5724 BENSON DR
BATON ROUGE, LA
70812-2603

Practice Phone: 225-371-4203
Practice Fax:

1134083983 — MS. LATWYLA MEKEL TERRELL
Practice Location Address:

5724 ATLANTA AVE
BATON ROUGE, LA
70812-2204

Practice Phone: 225-469-6565
Practice Fax:

1366387052 — BRANDI MATEN PLPC
Practice Location Address:

1920 KENTUCKY ST
BATON ROUGE, LA
70802-6662

Practice Phone: 225-614-6845
Practice Fax:

1144163858 — ALEXANDRA GIARDINA
Practice Location Address:

1820 WISTERIA ST
BATON ROUGE, LA
70802-4085

Practice Phone: 225-773-3037
Practice Fax:

1164416616 — BATON ROUGE SPEECH AND HEARING FOUNDATION, INC
Practice Location Address:

535 W ROOSEVELT ST
BATON ROUGE, LA
70802-7844

Practice Phone: 225-343-4232
Practice Fax: 225-343-4233

Directions to “MMO JENNINGS, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.