Provider Demographics
NPI:1992007348
Name:LA MANAGEMENT COMPANY
Entity Type:Organization
Organization Name:LA MANAGEMENT COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-252-0541
Mailing Address - Street 1:1125 DEER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-6680
Mailing Address - Country:US
Mailing Address - Phone:931-252-0541
Mailing Address - Fax:931-432-4242
Practice Address - Street 1:1125 DEER CREEK DR
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-6680
Practice Address - Country:US
Practice Address - Phone:931-252-0541
Practice Address - Fax:931-432-4242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445473OtherTENNCARE GROUP PROVIDER #