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1000 Mar Walt Dr Ft Walton Beach FL 32547-6708 | |
(850) 862-1111 | |
(850) 862-9149 |
Full Name | |
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Speciality | Psychiatric Unit |
Location | 1000 Mar Walt Dr, Ft Walton Beach, Florida |
Authorized Official Name and Position | Steve Moore (CFO) |
Authorized Official Contact | 8503151358 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1000 Mar Walt Dr Ft Walton Beach FL 32547-6708 Ph: (850) 862-1111 | 1000 Mar Walt Dr Ft Walton Beach FL 32547-6708 Ph: (850) 862-1111 |
NPI Number | 1326093246 |
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Provider Enumeration Date | 05/23/2006 |
Last Update Date | 03/30/2022 |
Certification Date | 03/30/2022 |
Medicare PECOS PAC ID | 0941220784 |
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Medicare Enrollment ID | O20070727000229 |
Identifier | Type | State | Issuer |
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1326093246 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |