| Life Management Center Of Northwest Florida Inc | |
|
525 E 15th St Panama City FL 32405-5412 | |
| (850) 522-4480 | |
| (850) 914-6281 |
| Full Name | Life Management Center Of Northwest Florida Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 525 E 15th St, Panama City, Florida |
| Authorized Official Name and Position | Edwin R. Ailes (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8505228840 |
| 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 525 E 15th St Panama City FL 32405-5412 Ph: (850) 522-4480 |
| NPI Number | 1003022369 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 07/31/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003022369 | NPI | - | NPPES |
| 141301500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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