| Life Management Center Of Northwest Florida Inc | |
|
16869 Ne Pear St Blountstown FL 32424-1774 | |
| (850) 522-4480 | |
| (850) 914-6281 |
| Full Name | Life Management Center Of Northwest Florida Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 16869 Ne Pear St, Blountstown, Florida |
| Authorized Official Name and Position | Edwin Ailes (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8505224480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Management Center Of Northwest Florida Inc 525 E 15th St Panama City FL 32405-5412 Ph: (850) 522-4480 | Life Management Center Of Northwest Florida Inc 16869 Ne Pear St Blountstown FL 32424-1774 Ph: (850) 522-4480 |
| NPI Number | 1659301877 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 03/29/2024 |
| Certification Date | 03/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659301877 | NPI | - | NPPES |
| 060296538 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
Panhandle Therapy Center Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 20311 Central Ave W, Blountstown, FL 32424 Phone: 850-674-8888 Fax: 850-237-1223 |