MEDICARE: LOMF, INC.

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	253J00000X	Foster Care Agency

General Provider Information

NPI Number	:	1962146977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOMF, INC.

Provider Business Mailing Address
First Line	:	9449 COUNTY ROAD 172
Second Line	:
City	:	IOLA
State	:	TX
Zip	:	77861-4767
Country	:	US
Telephone Number	:	979-807-4060
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 S SAN ANTONIO ST
Second Line	:
City	:	HEARNE
State	:	TX
Zip	:	77859-2672
Country	:	US
Telephone Number	:	979-807-4060
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	DR. ANNA PICCOLO
Credential	:	EDD
Telephone Number	:	979-807-4060

Provider Enumeration Date	:	04/25/2022
Last Update Date	:	04/25/2022

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Directions to “LOMF, INC. ” Practice Location

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