LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC


Address: 525 East 15th Street, Panama City, FL 32405-0000
Phone: 8505224485

LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC (NPI# 1508854571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1508854571
Entity Type Organization
Organization Name LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC
Practice Address 525 East 15th Street
Panama City
FL 32405-0000
Mailing Address 525 E 15th St
Panama City
FL 32405-5412
Practice Telephone 8505224485
Practice Fax Number 8509146281
Mailing Telephone 8505224485
Mailing Fax Number 8509146281
Enumeration Date 2005-10-12
Last Update Date 2016-11-23
Authorized Official Name MR. EDWIN AILES (CEO/PRESIDENT)
Authorized Official Telephone 8505224485
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities
Y 2084P0800X Psychiatry & Neurology
Specialization: Psychiatry
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL 060296500 05
FL BLUE CROSS BLUE SHIELD 99260 01

Other Provider IDs and Locations

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
1003022369 Life Management Center of Northwest Florida Inc Community/Behavioral Health 525 E 15th St, Panama City, FL 32405-5412 2007-05-15
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

Office Location

Street Address 525 EAST 15TH STREET
City PANAMA CITY
State FL
Zip Code 32405-0000

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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
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Taxonomy Information

Taxonomy Code 2084P0800X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Psychiatry

Taxonomy Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245501378 Edward D. Gibson Jr Md Pa Psychiatry & Neurology 1514 W 23rd St Ste A-4, Panama City, FL 32405-2905 2012-01-20
1386837961 John Terry Renick Psychiatry & Neurology 1108 Clay Ave, Panama City, FL 32401-1673 2007-08-27
1427159516 Paul Jon Gitlin Psychiatry & Neurology 525 E 15th Street, Panama City, FL 32405-5412 2006-09-25
1205885753 John Roy Billingsley Psychiatry & Neurology 102 Springhill Cir, Panama City, FL 32405-3546 2006-05-10
1962489484 Luis N Zumarraga Psychiatry & Neurology 2003 Wilson Ave, Panama City, FL 32405-4532 2005-12-27
1760482509 Gary D Gorman Psychiatry & Neurology 217 Forest Park Cir, Panama City, FL 32405-4916 2005-07-22
1366448615 Paul H Wurst Psychiatry & Neurology 525 E 15th St, Panama City, FL 32405-5412 2005-06-22
1427051937 Paul Kenneth Phillips Psychiatry & Neurology 1940 Harrison Ave, Panama City, FL 32405-4542 2005-05-30
1134530660 Royce Paul Gray Psychiatry & Neurology 1940 Harrison Ave, Panama City, FL 32405 2014-05-19
1245664531 Walter David Smith Psychiatry & Neurology 1940 Harrison Ave, Panama City, FL 32405-4542 2013-08-22
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Competitor

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City PANAMA CITY
Zip Code 32405

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Dataset Information

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.

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