Healthcare Provider Details

I. General information

NPI: 1689020489
Provider Name (Legal Business Name): O&M FAMILY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 N MORRISON BLVD
HAMMOND LA
70401-2242
US

IV. Provider business mailing address

PO BOX 2162
HAMMOND LA
70404-2162
US

V. Phone/Fax

Practice location:
  • Phone: 985-551-5155
  • Fax: 985-551-5222
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: TIMOTHY O'NEAL SHOWERS
Title or Position: MBR
Credential:
Phone: 985-520-5697