Provider Demographics
NPI:1760126775
Name:LOMF, INC.
Entity Type:Organization
Organization Name:LOMF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PICCOLO
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:979-807-4060
Mailing Address - Street 1:9449 COUNTY ROAD 172
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:TX
Mailing Address - Zip Code:77861-4767
Mailing Address - Country:US
Mailing Address - Phone:979-807-4060
Mailing Address - Fax:
Practice Address - Street 1:106 S SAN ANTONIO ST
Practice Address - Street 2:
Practice Address - City:HEARNE
Practice Address - State:TX
Practice Address - Zip Code:77859-2672
Practice Address - Country:US
Practice Address - Phone:979-807-4060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children