LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC (NPI# 1003022369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003022369 |
| Entity Type | Organization |
| Organization Name | LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC |
| Practice Address |
525 E 15th St Panama City FL 32405-5412 |
| Practice Telephone | 8505224480 |
| Practice Fax Number | 8509146281 |
| Mailing Telephone | 8505224480 |
| Mailing Fax Number | 8509146281 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2008-07-31 |
| Authorized Official Name | MR. EDWIN R. AILES (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8505228840 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 141301500 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861422099 | Life Management Center of Northwest Florida Inc | Psychiatry & Neurology | 801 S Weeks St, Bonifay, FL 32425-3046 | 2006-07-04 |
| 1659301877 | Life Management Center of Northwest Florida Inc | Psychiatry & Neurology | 16869 Ne Pear St, Blountstown, FL 32424-1774 | 2006-07-04 |
| 1508854571 | Life Management Center of Northwest Florida Inc | Clinic/Center | 525 East 15th Street, Panama City, FL 32405-0000 | 2005-10-12 |
| 1467487876 | Life Management Center of Northwest Florida Inc | Counselor | 525 E 15th St, Panama City, FL 32405-5412 | 2006-07-12 |
| 1710912886 | Life Management Center of Northwest Florida Inc | Psychiatry & Neurology | 310 E Byrd Ave, Bonifay, FL 32425-3006 | 2006-07-11 |
| 1316977515 | Life Management Center of Northwest Florida Inc | Clinic/Center | 311 Williams Ave, Port St Joe, FL 32456-1845 | 2006-07-04 |
| 1255367579 | Life Management Center of Northwest Florida Inc | Psychiatry & Neurology | 4094 Lafayette St, Marianna, FL 32446-5648 | 2006-06-26 |
| Street Address |
525 E 15TH ST |
| City | PANAMA CITY |
| State | FL |
| Zip Code | 32405-5412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366448615 | Paul H Wurst | Psychiatry & Neurology | 525 E 15th St, Panama City, FL 32405-5412 | 2005-06-22 |
| 1093342552 | Roseth E Kyerematen | Registered Nurse | 525 E 15th St, Panama City, FL 32405-5412 | 2020-03-25 |
| 1912532144 | Pamela E. Wallace | Registered Nurse | 525 E 15th St, Panama City, FL 32405-5412 | 2020-03-09 |
| 1609419936 | Timothy Arrant | Counselor | 525 E 15th St, Panama City, FL 32405-5400 | 2019-10-18 |
| 1801440763 | Jennifer Sue Davis | Registered Nurse | 525 E 15th St, Panama City, FL 32405-5400 | 2019-07-30 |
| 1598327082 | Lydia Munoz | Licensed Practical Nurse | 525 E 15th St, Panama City, FL 32405-5412 | 2019-07-03 |
| 1831750066 | Antonio L Campbell | Licensed Practical Nurse | 525 E 15th St, Panama City, FL 32405-5400 | 2019-06-27 |
| 1831757715 | Amanda Nicole Odell | Registered Nurse | 525 E 15th St, Panama City, FL 32405-5400 | 2019-06-05 |
| 1396203824 | Victoria Augusta Terry | Registered Nurse | 525 E 15th St, Panama City, FL 32405-5412 | 2019-03-04 |
| 1891250296 | Luke Abbey | Registered Nurse | 525 E 15th St, Panama City, FL 32405-5400 | 2019-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457962136 | Kimberlea Fox | Behavioral Analyst | 4750 Collegiate Drive, Technology Building 157, Panama City, FL 32405 | 2020-08-14 |
| 1598325714 | Covenant Home Health Care, LLC | Home Health | 107 W. 19th Street, Panama City, FL 32405 | 2019-06-19 |
| 1467921403 | Amy Hancock | Counselor | 1212 W. 19th St., Panama City, FL 32405 | 2018-11-20 |
| 1063991917 | Patricia Kagendo Mutunga | Day Training, Developmentally Disabled Services | 2813 Fairmont Dr, Panama City, FL 32405 | 2018-08-11 |
| 1871087882 | Southeastern Dermatology Group Pa | Pharmacy | 2505 Harrison Ave Ste A, Panama City, FL 32405 | 2018-06-22 |
| 1346733615 | Jessica Nicole Graham | Nurse Practitioner | 2507 Harrison Ave Unit 101, Panama City, FL 32405 | 2018-06-12 |
| 1437658424 | Coastal Mobility Transportation, LLC | Non-emergency Medical Transport (VAN) | 203 Forest Park Circle, Panama City, FL 32405 | 2018-02-06 |
| 1003314915 | The Anti-aging Clinic of Northwest Florida | Obstetrics & Gynecology | 3019 Osprey Cir, Panama City, FL 32405 | 2018-01-25 |
| 1255848487 | Sarah Theriot | Social Worker | 700 W 23rd St Bldg H, Panama City, FL 32405 | 2018-01-09 |
| 1336686054 | Angela Leake | Registered Nurse | 449 W 23 St, Panama City, FL 32405 | 2017-01-20 |
| Find all providers in zip 32405 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215597455 | Bay County Healthcare Services, LLC | Community/Behavioral Health | 1530 Harrison Ave, Panama City, FL 32405-4619 | 2019-06-19 |
| 1831600618 | Marvellous Behavioral Health & Mediation, LLC | Community/Behavioral Health | 1015 Grace Ave Ste B, Panama City, FL 32401-2494 | 2017-10-19 |
| 1629363999 | Welcome Home Vets, Inc. | Community/Behavioral Health | 433 Harrison Ave, Panama City, FL 32401-2731 | 2011-06-15 |
| 1285951509 | Restoration Home Inc. | Community/Behavioral Health | 1313 E 11th St, Panama City, FL 32401-4116 | 2010-04-26 |
| 1306014105 | Florida State University | Community/Behavioral Health | 4750 Collegiate Dr, Above All Florida State University, Panama City, FL 32405-1000 | 2008-02-14 |
| 1720136203 | Children's Home Society of Florida | Community/Behavioral Health | 211 S Jan Dr, Panama City, FL 32404-7972 | 2007-01-08 |
| 1033726559 | Solid Rock Solutions LLC | Community/Behavioral Health | 2809 W 15th St, Panama City, FL 32401-1358 | 2020-09-29 |
| 1437645009 | Square Pegs Behavior Solutions LLC | Community/Behavioral Health | 904 Flower Ave, Panama City, FL 32401-1945 | 2018-07-07 |
| 1043716046 | Lynne Schneider, LLC | Community/Behavioral Health | 2682 Chapman Dr, Panama City, FL 32405-4914 | 2018-03-30 |
| 1407301757 | Gulf Coast Addiction Medicine | Community/Behavioral Health | 277 Forest Park Cir, Panama City, FL 32405-4920 | 2016-08-16 |
| Find all providers in PANAMA CITY | ||||
| City | PANAMA CITY |
| Zip Code | 32405 |
Please comment or provide details below to improve the information on LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.