| Life Management Center Of Northwest Florida Inc | |
|
311 Williams Ave Port St Joe FL 32456-1845 | |
| (850) 522-4480 | |
| (850) 914-6281 |
| Full Name | Life Management Center Of Northwest Florida Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 311 Williams Ave, Port St Joe, Florida |
| Authorized Official Name and Position | Edwin Ailes (CEO/PRESIDENT) |
| Authorized Official Contact | 8505224485 |
| 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 311 Williams Ave Port St Joe FL 32456-1845 Ph: (850) 522-4480 |
| NPI Number | 1316977515 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 03/29/2024 |
| Certification Date | 01/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316977515 | NPI | - | NPPES |
| 060296530 | Medicaid | FL |
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