Provider Demographics
NPI:1154702710
Name:M & M BEHAVIORAL HEALTH CENTER LLC
Entity type:Organization
Organization Name:M & M BEHAVIORAL HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-807-6946
Mailing Address - Street 1:712 FIRST ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232-2421
Mailing Address - Country:US
Mailing Address - Phone:318-878-6696
Mailing Address - Fax:318-878-6698
Practice Address - Street 1:712 FIRST ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232-2421
Practice Address - Country:US
Practice Address - Phone:318-878-6696
Practice Address - Fax:318-878-6698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty